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NPI Code Detail

MEDICARE: REBECCA M. ROURKE PA-C

MEDICARE: REBECCA M. ROURKE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMA054117PA

General Provider Information

NPI Number : 1396070975
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA M. ROURKE PA-C
Provider Business Mailing Address
First Line : 311 W 24TH ST
Second Line : ST 101
City : ERIE
State : PA
Zip : 16502-2668
Country : US
Telephone Number : 814-452-4214
Fax Number : 814-459-7823
Provider Business Practice Location Address
First Line : 311 W 24TH ST
Second Line : ST 101
City : ERIE
State : PA
Zip : 16502-2668
Country : US
Telephone Number : 814-452-4214
Fax Number : 814-459-7823
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2009
Last Update Date : 10/05/2020

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Directions to “ REBECCA M. ROURKE PA-C” Practice Location

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