Provider Demographics
NPI:1467686964
Name:SCHRAUTH, JODI (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:SCHRAUTH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E WASHINGTON ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-2503
Mailing Address - Country:US
Mailing Address - Phone:262-335-4558
Mailing Address - Fax:262-335-6827
Practice Address - Street 1:333 E WASHINGTON ST STE 2100
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2503
Practice Address - Country:US
Practice Address - Phone:262-335-4558
Practice Address - Fax:262-335-6827
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI117031-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse