Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2018010676 | MO |
N | 2080P0214X | Pediatric Pulmonologist | 2018010676 | MO |
NPI | 1255694220 |
---|---|
Provider Name | Rebekah Joy Nevel |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65201-6626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2012 |
Last Update Date | 14/12/2018 |