Provider Demographics
NPI:1558094193
Name:SCHLETER, CANDIE JO NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:CANDIE
Middle Name:JO NICOLE
Last Name:SCHLETER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7221 ENGLE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-2233
Mailing Address - Country:US
Mailing Address - Phone:260-469-8223
Mailing Address - Fax:260-469-8201
Practice Address - Street 1:7221 ENGLE RD STE 220
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2233
Practice Address - Country:US
Practice Address - Phone:260-469-8223
Practice Address - Fax:260-469-8201
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28241138A163W00000X
IN71012794A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse