Provider Demographics
NPI:1356563811
Name:DURBIN, REBECCA L (PA)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:DURBIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:470 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-1871
Mailing Address - Country:US
Mailing Address - Phone:859-734-3482
Mailing Address - Fax:859-734-3432
Practice Address - Street 1:470 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1871
Practice Address - Country:US
Practice Address - Phone:859-734-3482
Practice Address - Fax:859-734-3432
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA979363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant