Healthcare Provider Details

I. General information

NPI: 1770055469
Provider Name (Legal Business Name): MRS. REBECCA JEAN BARCZAK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 COLEMAN STREET
HASTINGS PA
16646-0500
US

IV. Provider business mailing address

101 SUSQUEHANNA ST
NORTHERN CAMBRIA PA
15714-1243
US

V. Phone/Fax

Practice location:
  • Phone: 814-247-6593
  • Fax:
Mailing address:
  • Phone: 814-421-6577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP019811
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: