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General NPI Number Information
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NPI Number | 1851317952
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Entity Type | Individual
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Provider Name | REBEKAH J MANAHAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 220 N PENNSYLVANIA AVE
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City | COLUMBUS
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State | KS
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Zip | 66725-1110
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Country | US
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Telephone | 620-429-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 3 2200TH ST
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City | HUMBOLDT
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State | KS
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Zip | 66748-1592
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Country | US
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Telephone | 620-431-6837
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Fax |
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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 | KS0855
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License Number State | KS
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