De Carolis, Rebecca

De Carolis, Rebecca is an individual health care provider with primary practice located at 1105 6Th St , Traverse City MI 49684-2345. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. De Carolis, Rebecca can be contacted via phone (231) 935-8686.

Contact Information

Primary practice address
1105 6Th St Traverse City MI 49684-2345
Fax: (231) 935-8708
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601002849 Michigan

Profile Details

NPI number 1750500344
LBN Legal business name De Carolis, Rebecca
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750500344 NPPES
Michigan Other RD002849 BLUE CROSS

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