Provider Demographics
NPI:1073662904
Name:SKIVER, REBECCA LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:SKIVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:2464 E HARLAN DR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-9679
Mailing Address - Country:US
Mailing Address - Phone:812-299-4843
Mailing Address - Fax:812-234-3352
Practice Address - Street 1:501 E HOSPITAL LN
Practice Address - Street 2:SUITE 101
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4230
Practice Address - Country:US
Practice Address - Phone:812-234-0707
Practice Address - Fax:812-234-3352
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10000545A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant