Individual provider Active NPI

Rebecca L Putrah, ARNP, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Spencer, IA
National Provider Identifier
1104723436
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
H195023 Issued in IA
Practice address
1200 1St Ave E
Spencer, IA 51301-4342
Phone
(712) 264-6198
NPI assigned
Oct 21, 2026
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X H195023 IA Primary

Addresses

Primary practice location

1200 1St Ave E
Spencer, IA 51301-4342

Mailing address

326 N 18TH St
Estherville, IA 51334-1708

Other practice location 1

2301 Highway 71
Spirit Lake, IA 51360-1185
Phone (712) 336-1230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1792540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1104723436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 N 18TH ST",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014342",
            "telephone_number": "712-264-6198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Highway 71",
            "address_purpose": "LOCATION",
            "city": "Spirit Lake",
            "state": "IA",
            "postal_code": "513601185",
            "country_code": "US",
            "telephone_number": "712-336-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUTRAH",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "ARNP, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-21",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "H195023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.