Provider Demographics
NPI:1497574792
Name:MEHLIN, REBECCA (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MEHLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 NIVER AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6062
Mailing Address - Country:US
Mailing Address - Phone:505-920-9897
Mailing Address - Fax:
Practice Address - Street 1:607 NIVER AVE
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80260-6062
Practice Address - Country:US
Practice Address - Phone:505-920-9897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM66792163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse