Provider Demographics
NPI:1326277930
Name:RAUSA, REBECCA CARSON (PA-C)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:CARSON
Last Name:RAUSA
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:ATTN: FORCE MEDICAL CODE 04
Mailing Address - Street 2:2000 TRIDENT WAY, BLDG. 624
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92155-5599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SEAL TEAM TWO
Practice Address - Street 2:1840 GATOR BLVD, BLDG 3841
Practice Address - City:JEB LCRK-FORT STORY
Practice Address - State:VA
Practice Address - Zip Code:23459
Practice Address - Country:US
Practice Address - Phone:757-763-3308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant