Provider Demographics
NPI:1861405482
Name:GEBHARDS, REBEKAH ELIZABETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:ELIZABETH
Last Name:GEBHARDS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20075 STATE HIGHWAY Y
Mailing Address - Street 2:
Mailing Address - City:ROCK PORT
Mailing Address - State:MO
Mailing Address - Zip Code:64482-7121
Mailing Address - Country:US
Mailing Address - Phone:660-744-2161
Mailing Address - Fax:
Practice Address - Street 1:411 MAIN ST
Practice Address - Street 2:
Practice Address - City:TARKIO
Practice Address - State:MO
Practice Address - Zip Code:64491-1544
Practice Address - Country:US
Practice Address - Phone:660-736-5512
Practice Address - Fax:660-736-4361
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12030183500000X
MO2004033682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE12030OtherPHARMACIST LISCENSE
MO2004033682OtherPHARMACIST LISCENSE
IA20138OtherPHARMACY BOARD