Provider Demographics
NPI:1508036518
Name:STOCKSTILL, REBEKAH ANNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:ANNE
Last Name:STOCKSTILL
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 1:8700 PINEVILLE MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4750
Mailing Address - Country:US
Mailing Address - Phone:886-451-3467
Mailing Address - Fax:855-238-6036
Practice Address - Street 1:8700 PINEVILLE MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4750
Practice Address - Country:US
Practice Address - Phone:866-451-3467
Practice Address - Fax:855-238-6036
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005266363AM0700X
NC0010-03802363A00000X
SC2435363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical