MEDICARE: MRS. REBECCA G RANKIN P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA343	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144225111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA G RANKIN P.A.-C

Provider Business Mailing Address
First Line	:	132 FRONTIER BLVD STE 101
Second Line	:
City	:	STANFORD
State	:	KY
Zip	:	40484-6516
Country	:	US
Telephone Number	:	606-727-5757
Fax Number	:	606-727-5777

Provider Business Practice Location Address
First Line	:	132 FRONTIER BLVD STE 101
Second Line	:
City	:	STANFORD
State	:	KY
Zip	:	40484-6516
Country	:	US
Telephone Number	:	606-727-5757
Fax Number	:	606-727-5777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	10/04/2022

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