Provider Demographics
NPI:1164617379
Name:SCHNEBLY, KATHERINE LOUISE
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LOUISE
Last Name:SCHNEBLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E ANTIETAM ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5754
Mailing Address - Country:US
Mailing Address - Phone:301-797-8822
Mailing Address - Fax:301-790-3748
Practice Address - Street 1:324 E ANTIETAM ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5754
Practice Address - Country:US
Practice Address - Phone:301-797-8822
Practice Address - Fax:301-790-3748
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR164999363LF0000X
MI4704339284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily