Provider Demographics
NPI:1952306417
Name:ESPER, REBECCA L (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:ESPER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:L
Other - Last Name:PARKHURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:120 E 2ND ST THIRD FLOOR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1578
Mailing Address - Country:US
Mailing Address - Phone:814-877-8000
Mailing Address - Fax:814-452-2210
Practice Address - Street 1:120 E 2ND ST THIRD FLOOR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1578
Practice Address - Country:US
Practice Address - Phone:814-877-8000
Practice Address - Fax:814-452-2210
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002750L363A00000X
NY018651-01363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA970023782OtherRAILROAD MEDICARE IND#
PAP36996Medicare UPIN
PA970023782OtherRAILROAD MEDICARE IND#