Provider Demographics
NPI:1992276521
Name:YOUSE, REBEKAH LYNNE (PA-C)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LYNNE
Last Name:YOUSE
Suffix:
Gender:
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 1:912 MESA LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-4144
Mailing Address - Country:US
Mailing Address - Phone:570-789-0059
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8521
Practice Address - Fax:717-531-5068
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2025-03-10
Deactivation Date:2018-12-07
Deactivation Code:
Reactivation Date:2018-12-12
Provider Licenses
StateLicense IDTaxonomies
PAMA060462363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical