Provider Demographics
NPI:1952594871
Name:MILORA, REBECCA D (MSN, CRNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:D
Last Name:MILORA
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 GALLOWAY RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2983
Mailing Address - Country:US
Mailing Address - Phone:215-638-0629
Mailing Address - Fax:215-638-1192
Practice Address - Street 1:2185 GALLOWAY RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2983
Practice Address - Country:US
Practice Address - Phone:215-638-0629
Practice Address - Fax:215-638-1192
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
PASP007527363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No133N00000XDietary & Nutritional Service ProvidersNutritionist