| Doctor Name: | REBEKAH LYNN PETKOFF |
| NPI Number: | 1003069774 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 13686 |
| Business Practice Address: | 12959 S Parker Rd Parker, CO - 801343447 |
| Business Phone Number: | 7208424089 |
| Business Fax Number: | 7208424090 |
| Mailing Address: | 1560 S Ash St, DENVER |
| State: | CO |
| Postal Code: | 802223703 |
| Phone Number: | 6159690007 |
| Fax Number: | |
| NPI Enumeration Date: | 10/28/2008 |
| NPI Last Update Date: | 06/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 13686 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |