Provider Demographics
NPI:1578037735
Name:REBER, REBEKAH (PA-C)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:REBER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:
Other - Last Name:ZETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6100 WHIPPLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7618
Mailing Address - Country:US
Mailing Address - Phone:937-947-7647
Mailing Address - Fax:
Practice Address - Street 1:6100 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7618
Practice Address - Country:US
Practice Address - Phone:937-947-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006419RX363A00000X
IA095025363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant