Provider Demographics
NPI:1407838345
Name:SCHLEGEL HAVIG, AMY (CRNA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SCHLEGEL HAVIG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LOUISE
Other - Last Name:SCHLEGEL HAVIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 413012
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-3012
Mailing Address - Country:US
Mailing Address - Phone:239-261-1158
Mailing Address - Fax:239-261-4232
Practice Address - Street 1:1336 CREEKSIDE BLVD
Practice Address - Street 2:STE 1
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1931
Practice Address - Country:US
Practice Address - Phone:239-261-1158
Practice Address - Fax:239-261-4232
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1476322367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305034300Medicaid
G2676OtherBCBS
FL305034300Medicaid