Basic Information
| Provider Information | |||||||||
| NPI: | 1881778223 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REBER | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1329 N BEAVER ST | ||||||||
| Address2: | |||||||||
| City: | FLAGSTAFF | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860013127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287732260 | ||||||||
| FaxNumber: | 9287732402 | ||||||||
| Practice Location | |||||||||
| Address1: | 1329 N BEAVER ST | ||||||||
| Address2: | |||||||||
| City: | FLAGSTAFF | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860013127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287732260 | ||||||||
| FaxNumber: | 9287732402 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WX0200X | RN-049368 | AZ | Y | Nursing Service Providers | Registered Nurse | Oncology |
No ID Information.