Provider Demographics
NPI:1619956588
Name:SCHAUVLIEGE, JOANN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:SCHAUVLIEGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 LOCUST ST
Mailing Address - Street 2:PO BOX 520
Mailing Address - City:LA CROSSE
Mailing Address - State:KS
Mailing Address - Zip Code:67548-9673
Mailing Address - Country:US
Mailing Address - Phone:785-222-2545
Mailing Address - Fax:785-222-2868
Practice Address - Street 1:801 LOCUST ST
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:KS
Practice Address - Zip Code:67548-9673
Practice Address - Country:US
Practice Address - Phone:785-222-2545
Practice Address - Fax:785-222-2868
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44288363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
160816Medicare ID - Type Unspecified
S39598Medicare UPIN