Healthcare Provider Details

I. General information

NPI: 1134835101
Provider Name (Legal Business Name): REBECCA CARRINGTON RISING PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 N CHURCH ST
GREENSBORO NC
27401-1007
US

IV. Provider business mailing address

4210 EMILY LOOP APT 3B
HIGH POINT NC
27265-0010
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-4400
  • Fax:
Mailing address:
  • Phone: 860-819-1427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-12973
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12973
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: