Provider Demographics
NPI:1841311511
Name:SCHNEIDER, DEBORAH L (CDM)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 874553
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-4553
Mailing Address - Country:US
Mailing Address - Phone:907-373-2672
Mailing Address - Fax:907-373-3672
Practice Address - Street 1:231 E SWANSON AVE
Practice Address - Street 2:STE 26
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7026
Practice Address - Country:US
Practice Address - Phone:907-373-2672
Practice Address - Fax:907-373-3672
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA31176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNM44012Medicaid