Provider Demographics
NPI:1376120584
Name:HEDRICK, REBEKKAH ANNE (DO)
Entity type:Individual
Prefix:
First Name:REBEKKAH
Middle Name:ANNE
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 444 BOX 1585
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96297-0016
Mailing Address - Country:US
Mailing Address - Phone:951-847-8254
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 3031 KEY STREET
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96297
Practice Address - Country:US
Practice Address - Phone:315-737-2558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN02007327A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program