Provider Demographics
NPI:1508000506
Name:YOUNG, REBECCA ANNE (CRNP MSN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ANNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:CRNP MSN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANNE
Other - Last Name:BAUDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2301 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4154
Mailing Address - Country:US
Mailing Address - Phone:717-397-2738
Mailing Address - Fax:717-397-7634
Practice Address - Street 1:2301 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4154
Practice Address - Country:US
Practice Address - Phone:717-397-2738
Practice Address - Fax:717-397-7634
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010270363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health