Provider Demographics
NPI:1326015785
Name:SCHNABEL, MARY A (PNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:SCHNABEL
Suffix:
Gender:F
Credentials:PNP
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Mailing Address - Street 1:8100 34TH AVE S
Mailing Address - Street 2:MAIL STOP 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1672
Mailing Address - Country:US
Mailing Address - Phone:952-883-5463
Mailing Address - Fax:952-883-5395
Practice Address - Street 1:451 N DUNLAP ST
Practice Address - Street 2:MAIL STOP 32700A
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4621
Practice Address - Country:US
Practice Address - Phone:651-999-4700
Practice Address - Fax:651-999-4781
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN1117099363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P12208Medicare UPIN