Provider Demographics
NPI:1053489641
Name:SLEEPER, REBECCA ANN (RN FNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:SLEEPER
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 EAST GENESEE STREET
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1934
Mailing Address - Country:US
Mailing Address - Phone:315-251-1093
Mailing Address - Fax:315-251-1571
Practice Address - Street 1:3906 EAST GENESEE STREET
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:NY
Practice Address - Zip Code:13214-1934
Practice Address - Country:US
Practice Address - Phone:315-251-1093
Practice Address - Fax:315-251-1571
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
324031OtherMVP HEALTHCARE
000921345001OtherHEALTHNOW