Provider Demographics
NPI:1649160946
Name:HENDERSON, REBEKAH MAY (RNFA)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:MAY
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6195 SHETLAND ST
Mailing Address - Street 2:
Mailing Address - City:STAGECOACH
Mailing Address - State:NV
Mailing Address - Zip Code:89429-9108
Mailing Address - Country:US
Mailing Address - Phone:916-390-3056
Mailing Address - Fax:
Practice Address - Street 1:1107 US HIGHWAY 395 N
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5304
Practice Address - Country:US
Practice Address - Phone:775-182-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV821309163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant