Provider Demographics
NPI:1689132185
Name:SCHOENECKER, PATRICK (CNP)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:SCHOENECKER
Suffix:
Gender:M
Credentials:CNP
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 92
Mailing Address - Street 2:
Mailing Address - City:MOUND
Mailing Address - State:MN
Mailing Address - Zip Code:55364-0092
Mailing Address - Country:US
Mailing Address - Phone:952-836-7849
Mailing Address - Fax:
Practice Address - Street 1:3640 TALMAGE CIR STE 216
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55110-7100
Practice Address - Country:US
Practice Address - Phone:952-431-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6465363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health