Individual
REBECCA L. CHITTENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1753 W RIDGEWAY AVE, SUITE 102, WATERLOO, IA 50701-4544
(319) 833-5888
(319) 833-5891
Mailing address
1753 W RIDGEWAY AVE, SUITE 102, WATERLOO, IA 50701-4544
(319) 833-5888
(319) 833-5891
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00751366
RR MEDICARE
IA
Enumeration date
04/28/2009
Last updated
10/22/2009
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