REBECCA PRUELLA ANDERSON NP NPI 1447365598

NPI Information

NPI: 1447365598
Provider Name: REBECCA PRUELLA ANDERSON, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
785 SUMMIT AVE STE 101
PROHEALTH CARE WOMEN'S CENTER
OCONOMOWOC, WI
ZIP 53066
Phone: (262) 569-0345
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Rebecca Pruella Anderson, NP is an adult health nurse practitioner in Oconomowoc, WI. Rebecca Pruella Anderson, NP NPI is 1447365598. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

785 SUMMIT AVE STE 101
PROHEALTH CARE WOMEN'S CENTER
OCONOMOWOC, WI
ZIP 53066-844
Phone: (262) 569-0345
Fax: (262) 569-0333

The NPI 1447365598 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 1/16/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	2574-033	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	41266700	OTHER	WISCONSIN	WISCONSIN MEDICAID PROGRAM
2	683750693	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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