Provider Demographics
NPI:1629578844
Name:SCHOMAKER, TAYLOR ANNE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:ANNE
Last Name:SCHOMAKER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:TAYLOR
Other - Middle Name:ANNE
Other - Last Name:ALFANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1103 LEDDY ROAD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48609
Mailing Address - Country:US
Mailing Address - Phone:989-274-5557
Mailing Address - Fax:
Practice Address - Street 1:1103 LEDDY ROAD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48609
Practice Address - Country:US
Practice Address - Phone:989-274-5557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86083161133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered