Provider Demographics
NPI:1568016889
Name:PROSCHER, DEBORAH L (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:PROSCHER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 S PARLIMAN RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-6817
Mailing Address - Country:US
Mailing Address - Phone:845-242-3625
Mailing Address - Fax:
Practice Address - Street 1:167 S PARLIMAN RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-6817
Practice Address - Country:US
Practice Address - Phone:845-242-3625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY473111163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator