Provider Demographics
NPI:1699770503
Name:CROUCHER, DEBORAH A (PA-C)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:CROUCHER
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:230 LEXINGTON GREEN CIR
Mailing Address - Street 2:STE 600
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3326
Mailing Address - Country:US
Mailing Address - Phone:859-971-4695
Mailing Address - Fax:859-971-4604
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:STE B485
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3797
Practice Address - Country:US
Practice Address - Phone:859-277-6143
Practice Address - Fax:859-277-8659
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2020-12-03
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Provider Licenses
StateLicense IDTaxonomies
KYPA028363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95003281Medicaid
KY95003281Medicaid
KY0030512Medicare ID - Type Unspecified