Provider Demographics
NPI:1427066760
Name:SCHILDER, DEBRA L (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:L
Last Name:SCHILDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:104 RAES CREEK CT
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8657
Mailing Address - Country:US
Mailing Address - Phone:859-263-0329
Mailing Address - Fax:859-263-2381
Practice Address - Street 1:151 N EAGLE CREEK DR
Practice Address - Street 2:SUITE 410
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1889
Practice Address - Country:US
Practice Address - Phone:859-263-0329
Practice Address - Fax:859-263-2381
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA-179363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP89042Medicare UPIN