Doctor Name: | MRS. REBECCA LYNN DEFFNER |
NPI Number: | 1578819256 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 2012007838 |
Business Practice Address: | 1881 County Trunk Xx Mosinee, WI - 54455 |
Business Phone Number: | 7153554040 |
Business Fax Number: | |
Mailing Address: | 2940 Flagstone Dr, WAUSAU |
State: | WI |
Postal Code: | 544018374 |
Phone Number: | 7153700289 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2012 |
NPI Last Update Date: | 07/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2012007838 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |