Provider Demographics
NPI:1245791847
Name:SCHNEIDER, JAMIE MICHELLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MICHELLE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 NORMAN D ACRES RD N
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-2445
Mailing Address - Country:US
Mailing Address - Phone:618-667-8234
Mailing Address - Fax:
Practice Address - Street 1:20 PROFESSIONAL PARK DR STE B
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5830
Practice Address - Country:US
Practice Address - Phone:618-288-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily