Provider Demographics
NPI:1154804847
Name:KAHN, REBECCA LYNN (MSPA, PA-C)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:KAHN
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Gender:F
Credentials:MSPA, PA-C
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Mailing Address - Street 1:6777 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3013
Mailing Address - Country:US
Mailing Address - Phone:248-325-0431
Mailing Address - Fax:248-325-0623
Practice Address - Street 1:6777 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3013
Practice Address - Country:US
Practice Address - Phone:313-694-0255
Practice Address - Fax:248-325-0623
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2021-03-31
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Provider Licenses
StateLicense IDTaxonomies
MI5601008805363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical