Healthcare Provider Details

I. General information

NPI: 1851750848
Provider Name (Legal Business Name): REBECCA LYNN PFEIFFER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 AVIATOR CT STE 210
VANDALIA OH
45377-9475
US

IV. Provider business mailing address

560 S LOOP RD
EDGEWOOD KY
41017-3405
US

V. Phone/Fax

Practice location:
  • Phone: 937-832-4773
  • Fax: 937-832-2986
Mailing address:
  • Phone: 859-301-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001983A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: