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NPI Code Detail

MEDICARE: REBECCA A ANDERSON P.A.

MEDICARE: REBECCA A ANDERSON P.A.
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 Assistant15-00320KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2003719148OTHERMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720054182
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA A ANDERSON P.A.
Provider Business Mailing Address
First Line : 4921 W 18TH ST
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2090
Country : US
Telephone Number : 785-830-0100
Fax Number : 785-830-0115
Provider Business Practice Location Address
First Line : 4921 W 18TH ST
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2090
Country : US
Telephone Number : 785-830-0100
Fax Number : 785-830-0115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 09/02/2021

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Directions to “ REBECCA A ANDERSON P.A.” Practice Location

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