Provider Demographics
NPI:1033466818
Name:SCHNEIDER, JOHANNA (PTA, RN)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:PTA, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2406
Mailing Address - Country:US
Mailing Address - Phone:828-712-6885
Mailing Address - Fax:
Practice Address - Street 1:12 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2406
Practice Address - Country:US
Practice Address - Phone:828-712-6885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY66000535225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant