Healthcare Provider Details

I. General information

NPI: 1699779967
Provider Name (Legal Business Name): DEBRA LEA SCHIPPER M.S.N., ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 EMPIRE BLVD
WEBSTER NY
14580-2104
US

IV. Provider business mailing address

1550 EMPIRE BLVD
WEBSTER NY
14580-2104
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-2214
  • Fax: 585-922-2388
Mailing address:
  • Phone: 585-922-2214
  • Fax: 585-922-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF300914-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: