Provider Demographics
NPI:1407939895
Name:DRESCHER, DEBRA L (NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:DRESCHER
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 1:11171 N 550 E
Mailing Address - Street 2:
Mailing Address - City:DEMOTTE
Mailing Address - State:IN
Mailing Address - Zip Code:46310-8947
Mailing Address - Country:US
Mailing Address - Phone:219-616-7887
Mailing Address - Fax:
Practice Address - Street 1:1103 EAST GRACE STREET
Practice Address - Street 2:CLINIC OF FAMILY MEDICINE
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-3210
Practice Address - Country:US
Practice Address - Phone:219-866-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002058A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health