Provider Demographics
NPI:1558772178
Name:YOTHERS LUCAS, DEBRA A (PA-C)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:YOTHERS LUCAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:YOTHERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1952 BRINKERTON RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-8226
Mailing Address - Country:US
Mailing Address - Phone:724-423-7475
Mailing Address - Fax:
Practice Address - Street 1:1952 BRINKERTON RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-8226
Practice Address - Country:US
Practice Address - Phone:724-423-7475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000309L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical