Provider Demographics
NPI:1659689123
Name:WINSLETT, REBECCA CATHERINE (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CATHERINE
Last Name:WINSLETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CATHERINE
Other - Last Name:DAVENPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4 CENTENNIAL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-7935
Mailing Address - Country:US
Mailing Address - Phone:978-531-0800
Mailing Address - Fax:
Practice Address - Street 1:4 CENTENNIAL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7935
Practice Address - Country:US
Practice Address - Phone:978-531-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA4037363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant