Provider Demographics
NPI:1295783868
Name:SCHULTZ, DEBORAH B (CRNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:B
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 KEISER BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3338
Mailing Address - Country:US
Mailing Address - Phone:610-685-8500
Mailing Address - Fax:610-685-4833
Practice Address - Street 1:2605 KEISER BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3338
Practice Address - Country:US
Practice Address - Phone:610-685-8500
Practice Address - Fax:610-685-4833
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004091U363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS61162Medicare UPIN