Provider Demographics
NPI:1477009249
Name:SCHNEIDER, TRESSA L (APN)
Entity Type:Individual
Prefix:
First Name:TRESSA
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:TRESSA
Other - Middle Name:L
Other - Last Name:BAER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:105 S LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:TREMONT
Mailing Address - State:IL
Mailing Address - Zip Code:61568-9572
Mailing Address - Country:US
Mailing Address - Phone:309-925-2961
Mailing Address - Fax:309-925-4221
Practice Address - Street 1:105 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:TREMONT
Practice Address - State:IL
Practice Address - Zip Code:61568-9572
Practice Address - Country:US
Practice Address - Phone:309-925-2961
Practice Address - Fax:309-925-4221
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-014791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner