Provider Demographics
NPI:1730451261
Name:ASHTON, REBECCA R (RN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:R
Last Name:ASHTON
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 1:125 COUNTY RD. 13A
Mailing Address - Street 2:P.O. BOX161
Mailing Address - City:SOUTH OTSELIC
Mailing Address - State:NY
Mailing Address - Zip Code:13155-0161
Mailing Address - Country:US
Mailing Address - Phone:315-653-7218
Mailing Address - Fax:315-653-7500
Practice Address - Street 1:125 COUNTY RD. 13A
Practice Address - Street 2:
Practice Address - City:SOUTH OTSELIC
Practice Address - State:NY
Practice Address - Zip Code:13155-0161
Practice Address - Country:US
Practice Address - Phone:315-653-7218
Practice Address - Fax:315-653-7500
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262646-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse