1326755935 NPI number — REBECCA LYNN HOSTUTTLER PT

Table of content: REBECCA LYNN HOSTUTTLER PT (NPI 1326755935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326755935 NPI number — REBECCA LYNN HOSTUTTLER PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOSTUTTLER
Provider First Name:
REBECCA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326755935
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WMC HOME HEALTH
Provider Second Line Business Mailing Address:
601 COLLIERS WAY
Provider Business Mailing Address City Name:
WEIRTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-797-6495
Provider Business Mailing Address Fax Number:
304-797-6496

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WMC HOME HEALTH
Provider Second Line Business Practice Location Address:
601 COLLIERS WAY
Provider Business Practice Location Address City Name:
WEIRTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-797-6495
Provider Business Practice Location Address Fax Number:
304-797-6496
Provider Enumeration Date:
11/02/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  001971 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)