Provider Demographics
NPI:1144870585
Name:STEIN, REBECCA L (MS, BSN, RN, ATC/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:STEIN
Suffix:
Gender:F
Credentials:MS, BSN, RN, ATC/L
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:L
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:430 HUNTERS CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:ODENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35120-5859
Mailing Address - Country:US
Mailing Address - Phone:606-627-1670
Mailing Address - Fax:
Practice Address - Street 1:430 HUNTERS CROSSING RD
Practice Address - Street 2:
Practice Address - City:ODENVILLE
Practice Address - State:AL
Practice Address - Zip Code:35120-5859
Practice Address - Country:US
Practice Address - Phone:606-627-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-177390163W00000X, 163W00000X
KYKY3652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No163W00000XNursing Service ProvidersRegistered Nurse