Provider Demographics
NPI:1447251962
Name:NEWCOMER, REBECCA A (CRNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:176 S COLDBROOK AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2712
Practice Address - Country:US
Practice Address - Phone:717-267-7480
Practice Address - Fax:717-267-7403
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007493363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102066407 0001Medicaid
PA867633OtherMEDICARE GROUP #
PASP007493OtherLICENSE
PA264510OtherMAMSI
PA1007307260034OtherMEDICAID GROUP #
PA25-1716306OtherMULTIPLAN/PHCS
PA444029OtherHEALTH AMERICA
PAG920-0100/233CCUOtherCAREFIRST
PA25-1716306OtherINTERGROUP
PA25-1716306OtherDEVON
PA50081232OtherCAPITAL BLUECROSS
PAP00017969OtherRAILROAD MEDICARE
PAP00017969OtherRAILROAD MEDICARE
PA867633OtherMEDICARE GROUP #
PA067060LN7Medicare PIN