Provider Demographics
NPI:1386985091
Name:NAME, DEBBIE ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:ANN
Last Name:NAME
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:DEBBIE
Other - Middle Name:ANN
Other - Last Name:SCHWALM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 FIRST TERRACE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:KS
Mailing Address - Zip Code:66043
Mailing Address - Country:US
Mailing Address - Phone:913-682-5588
Mailing Address - Fax:913-682-2698
Practice Address - Street 1:720 FIRST TERRACE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043
Practice Address - Country:US
Practice Address - Phone:913-682-5588
Practice Address - Fax:913-682-2698
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01567363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant