Provider Demographics
NPI:1417296864
Name:SCHNOPP, AMANDA LYNN (RN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:SCHNOPP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 ARGYLE AVE
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-3212
Mailing Address - Country:US
Mailing Address - Phone:631-428-4076
Mailing Address - Fax:
Practice Address - Street 1:73 ARGYLE AVE
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-3212
Practice Address - Country:US
Practice Address - Phone:631-428-4076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY659219-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY659219-1Medicaid