Polkabla, Rebecca Marie

Polkabla, Rebecca Marie is an individual health care provider with primary practice located at 15021 W Bell Rd Ste 125 , Surprise AZ 85374-3916. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Polkabla, Rebecca Marie can be contacted via phone (623) 476-7880.

Contact Information

Primary practice address
15021 W Bell Rd Ste 125 Surprise AZ 85374-3916
Phone: (623) 476-7880
Fax: (623) 476-7890
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4661 Arizona

Profile Details

NPI number 1649583238
LBN Legal business name Polkabla, Rebecca Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 23rd, 2010
Last updated Dec 5th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649583238 NPPES
Arizona Other Z302379 MEDICARE
Arizona MEDICAID 642812 MEDICARE

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