Provider Demographics
NPI:1104841220
Name:ANDERSON, REBECCA JONES (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JONES
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1100 TUNNEL RD
Mailing Address - Street 2:VAMC MEDICAL SERVICE
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2043
Mailing Address - Country:US
Mailing Address - Phone:828-298-2515
Mailing Address - Fax:828-299-5885
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:VAMC MEDICAL SERVICE
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2043
Practice Address - Country:US
Practice Address - Phone:828-298-2515
Practice Address - Fax:828-299-5885
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102288363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical