Koo, Rebecca Lynn
Koo, Rebecca Lynn is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Koo, Rebecca Lynn can be contacted via phone (602) 546-1900.Contact Information
Primary practice address
1919 E Thomas Rd
Phoenix AZ 85016-7710
Phone: (602) 546-1900
Fax: (602) 546-1918
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 209005271 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 177089 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | AP4842 | Arizona |
Profile Details
| NPI number | 1114122918 |
|---|---|
| LBN Legal business name | Koo, Rebecca Lynn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2007 |
| Last updated | Oct 30th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114122918 | NPPES |
| Wisconsin | MEDICAID | 1114122918 |
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