MEDICARE: REBECCA ANNE SWANBURG 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	2255A2300X	Athletic Trainer	AT-AT-10181353	OR
2	363A00000X	Physician Assistant	0010-12933	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0010-12933	OTHER	NC	MEDICAL LICENSE

General Provider Information

NPI Number	:	1962907097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA ANNE SWANBURG PA-C

Provider Business Mailing Address
First Line	:	629 SOUTHWICK PL
Second Line	:
City	:	MEBANE
State	:	NC
Zip	:	27302-0670
Country	:	US
Telephone Number	:	717-419-4942
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 ARRINGDON PARK DR STE 300
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-5677
Country	:	US
Telephone Number	:	919-660-5066
Fax Number	:

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

Provider Enumeration Date	:	03/29/2018
Last Update Date	:	08/26/2025

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