Provider Demographics
NPI:1194211219
Name:SCHAEFER, MELANIE RAE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:RAE
Last Name:SCHAEFER
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 1:70 SWEET SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:TN
Mailing Address - Zip Code:37348-6031
Mailing Address - Country:US
Mailing Address - Phone:931-675-1662
Mailing Address - Fax:
Practice Address - Street 1:615 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2504
Practice Address - Country:US
Practice Address - Phone:423-425-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program