Provider Demographics
NPI:1073741542
Name:SCHUCHART, PRUDENCE LYN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:PRUDENCE
Middle Name:LYN
Last Name:SCHUCHART
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:PRUDENCE
Other - Middle Name:LYN
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1 LEMOYNE SQ
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1230
Mailing Address - Country:US
Mailing Address - Phone:717-737-4511
Mailing Address - Fax:717-909-6659
Practice Address - Street 1:1 LEMOYNE SQ
Practice Address - Street 2:SUITE 201
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1230
Practice Address - Country:US
Practice Address - Phone:717-737-4511
Practice Address - Fax:717-909-6659
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010322363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2117428OtherHIGHMARK BLUE SHIELD
PA50107812OtherCAPITAL BLUE CROSS
PA1328102OtherCOVENTRY HEALTH AMERICA
PA1328102OtherCOVENTRY HEALTH AMERICA