Provider Demographics
NPI:1114379781
Name:JOSSEY, REBECCA CORRYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:CORRYN
Last Name:JOSSEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:CORRYN
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:330 ROBBINS STATION RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2277
Mailing Address - Country:US
Mailing Address - Phone:724-261-9958
Mailing Address - Fax:
Practice Address - Street 1:419 RODI RD
Practice Address - Street 2:
Practice Address - City:PENN HILLS
Practice Address - State:PA
Practice Address - Zip Code:15235-4520
Practice Address - Country:US
Practice Address - Phone:330-543-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005128RX363A00000X
PAMA061386363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant