| Doctor Name: | MRS. REBECCA VALENTINE WURMSTEIN |
| NPI Number: | 1588940506 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 642845 |
| Business Practice Address: | E Hwy 18 Pine Ridge, SD - 577700428 |
| Business Phone Number: | 6054419218 |
| Business Fax Number: | |
| Mailing Address: | Po Box 428, PINE RIDGE |
| State: | SD |
| Postal Code: | 577700428 |
| Phone Number: | 6054419218 |
| Fax Number: | |
| NPI Enumeration Date: | 10/24/2011 |
| NPI Last Update Date: | 05/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 642845 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |