Provider Demographics
NPI:1417618786
Name:BORG, REBECCA PAIGE (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:PAIGE
Last Name:BORG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 UPPER DRY FALLS CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-5952
Mailing Address - Country:US
Mailing Address - Phone:828-808-7714
Mailing Address - Fax:
Practice Address - Street 1:115 KILDAIRE PARK DR STE 406
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8144
Practice Address - Country:US
Practice Address - Phone:919-283-1099
Practice Address - Fax:984-220-9248
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-12490363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant