Provider Demographics
NPI:1295846798
Name:SCHROER, DEBRA (NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:SCHROER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 CASTLEWAY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1946
Mailing Address - Country:US
Mailing Address - Phone:317-567-1335
Mailing Address - Fax:317-567-1339
Practice Address - Street 1:113 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2176
Practice Address - Country:US
Practice Address - Phone:812-524-8388
Practice Address - Fax:812-524-8445
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001875A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN113150A2Medicare ID - Type Unspecified
INQ42166Medicare UPIN