Provider Demographics
NPI:1326617515
Name:SCHROETTNER, MAUREEN (FNP-C)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:SCHROETTNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 MADISON ST STE B
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-8033
Mailing Address - Country:US
Mailing Address - Phone:931-614-7169
Mailing Address - Fax:877-958-9018
Practice Address - Street 1:1947 MADISON ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8062
Practice Address - Country:US
Practice Address - Phone:931-614-7169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347701363LF0000X
TN34064363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN34064OtherTN STATE LICENSE