Provider Demographics
NPI:1881843316
Name:MYERS, REBECCA J (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:MYERS
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1300
Mailing Address - Fax:717-851-1310
Practice Address - Street 1:755 S PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:DALLASTOWN
Practice Address - State:PA
Practice Address - Zip Code:17313-9252
Practice Address - Country:US
Practice Address - Phone:717-851-1300
Practice Address - Fax:717-851-1310
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053563363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1577287OtherGATEWAY-WMG
PA2076270OtherHIGHMARK BLUE SHIELD
PA50081262OtherCAPITAL BLUE CROSS-WMG
PA1577287OtherGATEWAY-WMG