Healthcare Provider Details

I. General information

NPI: 1417037144
Provider Name (Legal Business Name): REBECCA ANN TERNENT PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 N MAIN STREET EXT
MEADVILLE PA
16335-1149
US

IV. Provider business mailing address

11851 LAKEVIEW DR
CONNEAUT LAKE PA
16316-3718
US

V. Phone/Fax

Practice location:
  • Phone: 814-724-3107
  • Fax: 814-724-3108
Mailing address:
  • Phone: 814-241-2922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP437849
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: