Koo, Rebecca Lynn

Koo, Rebecca Lynn is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Koo, Rebecca Lynn can be contacted via phone (602) 546-1900.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix AZ 85016-7710
Phone: (602) 546-1900
Fax: (602) 546-1918
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209005271 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 177089 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X AP4842 Arizona

Profile Details

NPI number 1114122918
LBN Legal business name Koo, Rebecca Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2007
Last updated Oct 30th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114122918 NPPES
Wisconsin MEDICAID 1114122918

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