Individual
MRS. REBECCA METZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 376-5757
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F08211308
IN
363LF0000X
Family Nurse Practitioner
Primary
71012609A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300066344
—
IN
01
—
IN2762365
MEDICARE
IN
Enumeration date
09/01/2021
Last updated
09/09/2024
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