Basic Information
| Provider Information | |||||||||
| NPI: | 1447251962 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEWCOMER | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 176 S COLDBROOK AVE | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172012712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172677480 | ||||||||
| FaxNumber: | 7172677403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2005 | ||||||||
| LastUpdateDate: | 11/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | SP007493 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 102066407 0001 | 05 | PA | MEDICAID | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | SP007493 | 01 | PA | LICENSE | OTHER | 264510 | 01 | PA | MAMSI | OTHER | 1007307260034 | 01 | PA | MEDICAID GROUP # | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 444029 | 01 | PA | HEALTH AMERICA | OTHER | G920-0100/233CCU | 01 | PA | CAREFIRST | OTHER | MN0916253 | 01 | PA | DEA | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 50081232 | 01 | PA | CAPITAL BLUECROSS | OTHER | P00017969 | 01 | PA | RAILROAD MEDICARE | OTHER |