Provider Demographics
NPI:1548583792
Name:CHARTERS, REBECCA (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CHARTERS
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 1:76 ALLDS ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4758
Mailing Address - Country:US
Mailing Address - Phone:603-560-4027
Mailing Address - Fax:
Practice Address - Street 1:76 ALLDS ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4758
Practice Address - Country:US
Practice Address - Phone:603-560-4027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA3947363A00000X
NH0890363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant