Provider Demographics
NPI:1548364664
Name:CONRAD, REBECCA ELIZABETH
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:CONRAD
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 1:1310 L ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NE
Mailing Address - Zip Code:68939
Mailing Address - Country:US
Mailing Address - Phone:308-425-8861
Mailing Address - Fax:
Practice Address - Street 1:1310 L ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NE
Practice Address - Zip Code:68939
Practice Address - Country:US
Practice Address - Phone:308-425-8861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1286153747P1801X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Not Answered376K00000XNursing Service Related ProvidersNurse's Aide