Provider Demographics
NPI:1699826594
Name:SCHWARTZ, DEBORA LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:LYNN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 SANDY ARBOR RD.
Mailing Address - Street 2:
Mailing Address - City:NEKOOSA
Mailing Address - State:WI
Mailing Address - Zip Code:54457-8974
Mailing Address - Country:US
Mailing Address - Phone:715-325-3285
Mailing Address - Fax:
Practice Address - Street 1:665 SANDY ARBOR RD.
Practice Address - Street 2:
Practice Address - City:NEKOOSA
Practice Address - State:WI
Practice Address - Zip Code:54457-8974
Practice Address - Country:US
Practice Address - Phone:715-325-3285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse