MEDICARE: REBECCA KATHERINE WESSLING 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
1	363A00000X	Physician Assistant	318	NH

General Provider Information

NPI Number	:	1396730982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KATHERINE WESSLING PA-C

Provider Business Mailing Address
First Line	:	6 TSIENNETO RD
Second Line	:
City	:	DERRY
State	:	NH
Zip	:	03038-1584
Country	:	US
Telephone Number	:	603-216-0400
Fax Number	:	603-216-3837

Provider Business Practice Location Address
First Line	:	6 TSIENNETO RD
Second Line	:
City	:	DERRY
State	:	NH
Zip	:	03038-1584
Country	:	US
Telephone Number	:	603-216-0400
Fax Number	:	603-216-3837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/08/2007

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