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General NPI Number Information
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NPI Number | 1508036518
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Entity Type | Individual
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Provider Name | REBEKAH ANNE STOCKSTILL PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 8700 PINEVILLE MATTHEWS RD
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City | CHARLOTTE
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State | NC
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Zip | 28226-4750
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Country | US
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Telephone | 866-451-3467
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Fax | 855-238-6036
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Provider Business Mailing Address
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Address Line | 8700 PINEVILLE MATTHEWS RD
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City | CHARLOTTE
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State | NC
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Zip | 28226-4750
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Country | US
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Telephone | 886-451-3467
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Fax | 855-238-6036
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 005266
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-03802
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2435
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License Number State | SC
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