Provider Demographics
NPI:1568070738
Name:SCHLOMER, BETH RENAE (RN, NNP-BC)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:RENAE
Last Name:SCHLOMER
Suffix:
Gender:F
Credentials:RN, NNP-BC
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:RENAE
Other - Last Name:SHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NNP-BC
Mailing Address - Street 1:1602 LEWIS LAKE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-4174
Mailing Address - Country:US
Mailing Address - Phone:719-339-4381
Mailing Address - Fax:
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8202
Practice Address - Country:US
Practice Address - Phone:904-202-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX955866163WN0002X
FLAPRN11010461363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care