Provider Demographics
NPI:1710395975
Name:SCHLABACH, TYRA RAE (MSN, FNP-C, AOCNP)
Entity Type:Individual
Prefix:MRS
First Name:TYRA
Middle Name:RAE
Last Name:SCHLABACH
Suffix:
Gender:F
Credentials:MSN, FNP-C, AOCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 BEALL AVE
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2342
Mailing Address - Country:US
Mailing Address - Phone:330-263-8763
Mailing Address - Fax:330-263-8190
Practice Address - Street 1:1761 BEALL AVE STE 1
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2342
Practice Address - Country:US
Practice Address - Phone:303-262-2800
Practice Address - Fax:303-262-2807
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.15774363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily