Healthcare Provider Details

I. General information

NPI: 1669794376
Provider Name (Legal Business Name): REBEKAH LYNN MACASKILL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16318 MONUMENT ROCK CT
MONUMENT CO
80132-6199
US

IV. Provider business mailing address

16318 MONUMENT ROCK CT
MONUMENT CO
80132-6199
US

V. Phone/Fax

Practice location:
  • Phone: 910-685-0982
  • Fax: 817-476-7456
Mailing address:
  • Phone: 910-685-0982
  • Fax: 817-476-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA.0006481
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0006481
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: