Provider Demographics
NPI:1659656833
Name:SCHAAL-BATES, GRETCHEN L (LPN)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:L
Last Name:SCHAAL-BATES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:NY
Mailing Address - Zip Code:14519-9372
Mailing Address - Country:US
Mailing Address - Phone:585-507-3790
Mailing Address - Fax:
Practice Address - Street 1:819 BOSTON RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:NY
Practice Address - Zip Code:14519-9372
Practice Address - Country:US
Practice Address - Phone:585-507-3790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2012-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287999164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse