Provider Demographics
NPI:1265866834
Name:LUKE, REBECCA (PA-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LUKE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CORPORATE DR STE 107
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-7941
Mailing Address - Country:US
Mailing Address - Phone:814-842-3206
Mailing Address - Fax:814-842-9169
Practice Address - Street 1:104 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-1013
Practice Address - Country:US
Practice Address - Phone:814-263-5804
Practice Address - Fax:814-310-2008
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC05169363A00000X
PAMA059586363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant