| NPI | 1174144711 |
|---|---|
| Former Name | REBECCA C PUCKETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61354505) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: OH 50.00666RX) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2023-08-23 |