Provider Demographics
NPI:1629545827
Name:SCHLAFHAUSER, AUTUMN LEIGH (CRNP)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:LEIGH
Last Name:SCHLAFHAUSER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-284-4060
Mailing Address - Fax:724-284-4144
Practice Address - Street 1:127 ONEIDA VALLEY RD STE 400
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2251
Practice Address - Country:US
Practice Address - Phone:866-620-6761
Practice Address - Fax:724-282-3043
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019632363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP019632OtherLICENSE