Individual
REBECCA R WELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 S TELEPHONE RD, STE. 250, MOORE, OK 73160-2968
(405) 237-7507
Mailing address
2900 S TELEPHONE RD, STE. 250, MOORE, OK 73160-2968
(810) 280-3297
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2125
OK
363A00000X
Physician Assistant
5601004125
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RW004125
STATE LISC
MI
Enumeration date
08/04/2006
Last updated
11/10/2020
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