Provider Demographics
NPI:1417553371
Name:SCHAUM, AMANDA CONSTANCE (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CONSTANCE
Last Name:SCHAUM
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3267 BEE CAVE RD.
Mailing Address - Street 2:SUITE 107 PMB 276
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:913-439-7572
Mailing Address - Fax:
Practice Address - Street 1:3267 BEE CAVE RD.
Practice Address - Street 2:SUITE 107 PMB 276
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:913-439-7572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-157726163WL0100X
TX743371163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse