Provider Demographics
NPI:1467410654
Name:SCHNEIDER, PAULINE R (ARNP)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:R
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6119 NW 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4283
Mailing Address - Country:US
Mailing Address - Phone:352-336-1460
Mailing Address - Fax:
Practice Address - Street 1:3404 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-2409
Practice Address - Country:US
Practice Address - Phone:352-373-2507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2221362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL921211484216-001OtherMEDICARE CCN
FL307271100Medicaid