MEDICARE: MS. REBEKAH MICHELLE HOSMAN 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	363AM0700X	Medical Physician Assistant	9847199-1206	UT

General Provider Information

NPI Number	:	1982157301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBEKAH MICHELLE HOSMAN PA-C

Provider Business Mailing Address
First Line	:	45 E 400 S APT 5
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84606-4675
Country	:	US
Telephone Number	:	805-637-5992
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 N UNIVERSITY AVE
Second Line	:	#200
City	:	PROVO
State	:	UT
Zip	:	84604-6656
Country	:	US
Telephone Number	:	801-375-7100
Fax Number	:

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

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	09/16/2019

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