Provider Demographics
NPI:1972088938
Name:MILLER, REBEKAH J (PA-C)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:BATTLEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27809-9100
Mailing Address - Country:US
Mailing Address - Phone:814-414-2014
Mailing Address - Fax:
Practice Address - Street 1:2817 WOOTEN BLVD SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8625
Practice Address - Country:US
Practice Address - Phone:252-991-6800
Practice Address - Fax:252-991-6801
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08476363A00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine