Provider Demographics
NPI:1437700945
Name:LORD SCHOENBECK, TERESA (LPN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:LORD SCHOENBECK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:LORD SCHOENBECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:884 SHOEMAKE RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30116-9263
Mailing Address - Country:US
Mailing Address - Phone:608-843-5673
Mailing Address - Fax:
Practice Address - Street 1:52 PERRY ST
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1974
Practice Address - Country:US
Practice Address - Phone:678-854-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN095957164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse