Provider Demographics
NPI:1760622849
Name:SCHNEIDERS, SARA L (PA-C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:SCHNEIDERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 39TH AVE
Mailing Address - Street 2:PO BOX 207
Mailing Address - City:AMANA
Mailing Address - State:IA
Mailing Address - Zip Code:52203-8229
Mailing Address - Country:US
Mailing Address - Phone:319-622-3231
Mailing Address - Fax:319-622-3077
Practice Address - Street 1:505 39TH AVE
Practice Address - Street 2:
Practice Address - City:AMANA
Practice Address - State:IA
Practice Address - Zip Code:52203-8229
Practice Address - Country:US
Practice Address - Phone:319-622-3231
Practice Address - Fax:319-622-3077
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001979363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00797321OtherRAILROAD MEDICARE
IAI7495002Medicare PIN
IAP00797321OtherRAILROAD MEDICARE