1447552856 NPI number — DR. REBECCA LYNNE BILLINGS PH.D.

Table of content: JAMES NICHOLSON (NPI 1326504192)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447552856 NPI number — DR. REBECCA LYNNE BILLINGS PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BILLINGS
Provider First Name:
REBECCA
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447552856
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1373B WEST 6TH STREET
Provider Second Line Business Mailing Address:
FRONTIER PLACE
Provider Business Mailing Address City Name:
ERIE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16505-2503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-969-0231
Provider Business Mailing Address Fax Number:
844-330-2290

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1373B WEST 6TH STREET
Provider Second Line Business Practice Location Address:
FRONTIER PLACE
Provider Business Practice Location Address City Name:
ERIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16505-2503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-969-0231
Provider Business Practice Location Address Fax Number:
844-330-2290
Provider Enumeration Date:
11/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PS016907 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 102536236-004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102536236-003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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