Provider Demographics
NPI:1043591001
Name:BOUST, REBECCA RENE' (CRNA)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:RENE'
Last Name:BOUST
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:810 RAVENHILL DR
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-9204
Mailing Address - Country:US
Mailing Address - Phone:913-367-5360
Mailing Address - Fax:913-674-2013
Practice Address - Street 1:800 RAVENHILL DR
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-9204
Practice Address - Country:US
Practice Address - Phone:913-367-5360
Practice Address - Fax:913-674-2013
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60246708367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered