Healthcare Provider Details

I. General information

NPI: 1225758568
Provider Name (Legal Business Name): DEBBIE LEE SCHREPPEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 W DOMINICK ST
ROME NY
13440-5859
US

IV. Provider business mailing address

227 W DOMINICK ST
ROME NY
13440-5859
US

V. Phone/Fax

Practice location:
  • Phone: 315-336-6230
  • Fax:
Mailing address:
  • Phone: 315-336-6230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number404994
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: