Provider Demographics
NPI:1538966015
Name:ANDERSON, REBECCA ELLINGTON
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELLINGTON
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 S 74TH ST APT 301
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1753
Mailing Address - Country:US
Mailing Address - Phone:402-378-2282
Mailing Address - Fax:
Practice Address - Street 1:1724 S 74TH ST APT 301
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1753
Practice Address - Country:US
Practice Address - Phone:402-378-2282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health