Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
REBECCA DEATHERAGE BUWALDA, APRNBC
ActiveNurse Practitioner · BRIDGETON, MO
Registration Details
- NPI Number
- 1366477226
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 11, 2006 (19.785338853725 yrs)
- Last Updated
- Oct 20, 2020
- License
-
FNP 124462 (MO)
Practice Information
- Address
-
12255 DE PAUL DR STE 600BRIDGETON, MO, 630442515Browse MO providers · Browse ZIP 63044
- Phone
- 3142095100
- Fax
- 3142919508
- Primary Specialty
-
Nurse Practitioner
363L00000X
Other Nurse Practitioner Providers in BRIDGETON, MO
| Name | Credential | NPI |
|---|---|---|
| DEBRA E SOLOM | A.N.P. | 1003848516 |
| MR. MATTHEW W. BRUNS | CNP | 1447266333 |
| JAINA VALLARTA | RN, MSN, APRN-BC | 1497851448 |
| LAVADA JEAN SMITH | ANP | 1164691945 |
| AGNES CHAN LEWIS | ANP | 1821360454 |
| MARY F HANS | WHNP-BC | 1457604878 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.