Individual
REBECCA SUE PENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
219 E EUCLID AVE, MONMOUTH, IL 61462-1247
(309) 734-9461
(309) 734-3909
Mailing address
1007 230TH ST, ALEDO, IL 61231-8533
(309) 582-1116
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
077683
IA
163WC0400X
Case Management Registered Nurse
041.246874
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
041.246874
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041.246874
R N LICENSE
IL
01
—
077683
R N LICENSE
IA
01
—
370984175
BWAY INC FEIN
IL
Enumeration date
04/13/2007
Last updated
04/17/2009
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