| NPI | 1629508783 |
|---|---|
| Former Name | REBECCA ELLENBERGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA APRN-NP209240) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 209240) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2025-10-14 |