Provider Demographics
NPI:1497129720
Name:WEBB, REBECCA (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WEBB
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 1:8540 SCARBOROUGH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7518
Mailing Address - Country:US
Mailing Address - Phone:719-364-6970
Mailing Address - Fax:719-365-7667
Practice Address - Street 1:8540 SCARBOROUGH DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7518
Practice Address - Country:US
Practice Address - Phone:719-364-6970
Practice Address - Fax:719-365-7667
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108847363A00000X
COPA.00045459363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant