Provider Demographics
NPI:1588002109
Name:HAHN, REBECCA KATHRYN LOUISE (PA-C, ATC)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:KATHRYN LOUISE
Last Name:HAHN
Suffix:
Gender:F
Credentials:PA-C, ATC
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Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-466-2451
Mailing Address - Fax:717-466-2453
Practice Address - Street 1:4131 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9550
Practice Address - Country:US
Practice Address - Phone:717-466-2451
Practice Address - Fax:717-466-2453
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOA005186363AS0400X, 363A00000X
20000134992255A2300X
PAMA061492363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical