| NPI | 1972980274 | 
|---|---|
| Former Name | REBECCA LYNN LICHWALA | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0036242) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9308901) | 
| Enumeration Date | 2015-05-06 | 
| Last Update Date | 2024-09-27 |