Provider Demographics
NPI:1467634048
Name:SCHUBBE, AUNDREA K (CPNP)
Entity Type:Individual
Prefix:
First Name:AUNDREA
Middle Name:K
Last Name:SCHUBBE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:AUDREA
Other - Middle Name:K
Other - Last Name:ARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:636-561-5707
Mailing Address - Fax:314-851-4489
Practice Address - Street 1:9101 PHOENIX VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-4279
Practice Address - Country:US
Practice Address - Phone:636-561-5707
Practice Address - Fax:314-851-4489
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704218696363LP0200X
OHNP06590363LP0200X
MO137476363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics