Provider Demographics
NPI:1700331030
Name:SCHLEICH, DEBORAH M (APN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:SCHLEICH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 KENNEDY MEMORIAL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4541
Mailing Address - Country:US
Mailing Address - Phone:207-861-7050
Mailing Address - Fax:207-861-7056
Practice Address - Street 1:180 KENNEDY MEMORIAL DR STE 201
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4541
Practice Address - Country:US
Practice Address - Phone:207-861-7050
Practice Address - Fax:207-861-7056
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014694363LF0000X
MECNP191159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400335559Medicare PIN