Provider Demographics
NPI:1124003017
Name:SCHNEIDER, SHELLY ROBIN (APN,C)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:ROBIN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 STOKES AVE
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4788
Mailing Address - Country:US
Mailing Address - Phone:856-853-0900
Mailing Address - Fax:856-853-5838
Practice Address - Street 1:17 W RED BANK AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1630
Practice Address - Country:US
Practice Address - Phone:856-853-0900
Practice Address - Fax:856-853-5838
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO074370000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health