Provider Demographics
NPI:1760174981
Name:SCHAUB, ANGELA KAY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAY
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 S SOUTH LONG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49685-8394
Mailing Address - Country:US
Mailing Address - Phone:231-313-0441
Mailing Address - Fax:
Practice Address - Street 1:2300 N STALLMAN RD
Practice Address - Street 2:
Practice Address - City:SUTTONS BAY
Practice Address - State:MI
Practice Address - Zip Code:49682-9158
Practice Address - Country:US
Practice Address - Phone:231-534-7477
Practice Address - Fax:231-534-7697
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704296794163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse