Provider Demographics
NPI:1043331762
Name:KANELLOS STONE, REBECCA A (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:KANELLOS STONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3 CEDAR CIR
Mailing Address - Street 2:
Mailing Address - City:SANDOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03873-2538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 CEDAR CIR
Practice Address - Street 2:
Practice Address - City:SANDOWN
Practice Address - State:NH
Practice Address - Zip Code:03873-2538
Practice Address - Country:US
Practice Address - Phone:603-887-3639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253519163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse