Provider Demographics
NPI:1801290325
Name:RECK, REBECCA (CRNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:RECK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 BIGLERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8019
Mailing Address - Country:US
Mailing Address - Phone:717-334-8165
Mailing Address - Fax:717-338-9070
Practice Address - Street 1:1311 BIGLERVILLE RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8019
Practice Address - Country:US
Practice Address - Phone:717-334-8165
Practice Address - Fax:717-338-9070
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014313363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily