Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 30350355 | WI |
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 3035-035 | WI |
NPI | 1043282106 |
---|---|
Provider Name | Dr. Rebecca Anne Kabat |
First Address | Eau Claire, WI 54701-4499 |
Second Address | Eau Claire, WI 54701-4499 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 24/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38627800 | (05) | WI |
V06652 | (02) |