Provider Demographics
NPI:1578293049
Name:SANDERS, REBEKAH S (CRNP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:S
Last Name:SANDERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:S
Other - Last Name:CHRISTIANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4000
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-4000
Mailing Address - Country:US
Mailing Address - Phone:484-330-1377
Mailing Address - Fax:
Practice Address - Street 1:1240 S CEDAR CREST BLVD STE 308
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6370
Practice Address - Country:US
Practice Address - Phone:610-402-1350
Practice Address - Fax:610-402-1356
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024764363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP024764OtherSTATE LICENSE