Provider Demographics
NPI:1508123225
Name:BIBRO, REBECCA ROSE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ROSE
Last Name:BIBRO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ROSE
Other - Last Name:KRINSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19723-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-4000
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:101 APPLIED BANK BLVD STE 11
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-3501
Practice Address - Country:US
Practice Address - Phone:484-800-8630
Practice Address - Fax:484-800-8635
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010579363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics