Basic Information
Provider Information
NPI: 1487027710
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OWNES
FirstName: REBECCA
MiddleName: EMILY
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 47 BRYN MAWR AVE
Address2:  
City: CHERRY HILL
State: NJ
PostalCode: 080021402
CountryCode: US
TelephoneNumber: 8565774028
FaxNumber:  
Practice Location
Address1: 252 S 4TH ST
Address2:  
City: LEBANON
State: PA
PostalCode: 170426111
CountryCode: US
TelephoneNumber: 7172707500
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/09/2015
LastUpdateDate: 12/19/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/19/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA058008PAN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363A00000XOA003701PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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