Provider Demographics
NPI:1003391905
Name:HORST, REBECCA (PA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HORST
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:817 PRINCETON AVE SW STE 306
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1349
Mailing Address - Country:US
Mailing Address - Phone:205-783-0160
Mailing Address - Fax:205-788-6249
Practice Address - Street 1:817 PRINCETON AVE SW STE 306
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1349
Practice Address - Country:US
Practice Address - Phone:205-783-0160
Practice Address - Fax:205-788-6249
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2023-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALPA.12382086S0129X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery