Provider Demographics
NPI:1477184323
Name:KANNEL, REBECCA BALDWIN (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:BALDWIN
Last Name:KANNEL
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:207 N BROAD ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:610-565-2100
Mailing Address - Fax:610-892-0626
Practice Address - Street 1:1088 W BALTIMORE PIKE
Practice Address - Street 2:4TH FLR STE 2400
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1906
Practice Address - Country:US
Practice Address - Phone:610-565-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2023-07-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant