Provider Demographics
NPI:1336676782
Name:SCHNITZER, TERESA LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LYNN
Last Name:SCHNITZER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:LYNN
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2002 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-4357
Mailing Address - Country:US
Mailing Address - Phone:309-794-1463
Mailing Address - Fax:
Practice Address - Street 1:4317 E 53RD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3860
Practice Address - Country:US
Practice Address - Phone:563-344-2400
Practice Address - Fax:563-344-2405
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IAA109975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program