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General NPI Number Information
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NPI Number | 1699770503
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Entity Type | Individual
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Provider Name | DEBORAH A CROUCHER PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 1401 HARRODSBURG RD STE B485
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City | LEXINGTON
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State | KY
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Zip | 40504-3797
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Country | US
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Telephone | 859-277-6143
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Fax | 859-277-8659
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Provider Business Mailing Address
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Address Line | 230 LEXINGTON GREEN CIR STE 600
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City | LEXINGTON
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State | KY
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Zip | 40503-3326
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Country | US
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Telephone | 859-971-4695
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Fax | 859-971-4604
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA028
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License Number State | KY
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