Rebecca Lynn Burgess

Individual provider Active NPI Community Health Worker · Baraboo, WI

NPI 1811409378 · NPPES record last updated Oct 24, 2017

Key facts

NPI
1811409378
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
840 State Road 136
Baraboo, WI 53913-9233
Phone
(608) 477-9858
NPI assigned
Oct 24, 2017
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

840 State Road 136
Baraboo, WI 53913-9233

Mailing address

417 Hitchcock St
Baraboo, WI 53913-2876

Other providers in Baraboo, WI

All providers in Baraboo, WI · Community Health Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.