Provider Demographics
NPI:1063609931
Name:STASKELUNAS, REBECCA WOODARD (PA-C)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:WOODARD
Last Name:STASKELUNAS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3316 ROUNDING BEND DR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-6100
Mailing Address - Country:US
Mailing Address - Phone:252-721-4794
Mailing Address - Fax:252-752-8941
Practice Address - Street 1:2101 W ARLINGTON BLVD STE 210
Practice Address - Street 2:EASTERN RADIOLOGIST, INC.
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5758
Practice Address - Country:US
Practice Address - Phone:252-752-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2015-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-01016363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant