Provider Demographics
NPI:1346871100
Name:SCHNEIDER, CHERYL ANN (LPN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-0476
Mailing Address - Country:US
Mailing Address - Phone:360-458-1900
Mailing Address - Fax:360-458-6178
Practice Address - Street 1:107 1ST ST N
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-7718
Practice Address - Country:US
Practice Address - Phone:360-458-1900
Practice Address - Fax:360-458-6178
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00045456164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00045456OtherLPN