Healthcare Provider Details

I. General information

NPI: 1962907097
Provider Name (Legal Business Name): REBECCA ANNE SWANBURG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA ANNE BRUBAKER ATHLETIC TRAINER

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 ARRINGDON PARK DR STE 300
MORRISVILLE NC
27560-5677
US

IV. Provider business mailing address

629 SOUTHWICK PL
MEBANE NC
27302-0670
US

V. Phone/Fax

Practice location:
  • Phone: 919-660-5066
  • Fax:
Mailing address:
  • Phone: 717-419-4942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12933
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-AT-10181353
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: