Provider Demographics
NPI:1306213780
Name:SCHNEIDER, CORY THOMAS (APRN)
Entity Type:Individual
Prefix:MR
First Name:CORY
Middle Name:THOMAS
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25045 COUNTY ROAD 137
Mailing Address - Street 2:
Mailing Address - City:O BRIEN
Mailing Address - State:FL
Mailing Address - Zip Code:32071-4325
Mailing Address - Country:US
Mailing Address - Phone:262-339-2191
Mailing Address - Fax:
Practice Address - Street 1:N848 COUNTY RD W
Practice Address - Street 2:
Practice Address - City:CAMPBELLSPORT
Practice Address - State:WI
Practice Address - Zip Code:53010-2402
Practice Address - Country:US
Practice Address - Phone:407-455-4472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2021-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6565-33363L00000X
FLARNP9409518363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner