Provider Demographics
NPI:1306847843
Name:ROPER, DEBBIE A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:A
Last Name:ROPER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 5TH AVENUE
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4210
Mailing Address - Country:US
Mailing Address - Phone:717-261-1269
Mailing Address - Fax:717-261-0664
Practice Address - Street 1:761 5TH AVE STE D
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4210
Practice Address - Country:US
Practice Address - Phone:717-261-1269
Practice Address - Fax:717-261-0664
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002765363A00000X
PAMA051770363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA098567ER1Medicare ID - Type Unspecified
PAQ23526Medicare UPIN