Provider Demographics
NPI:1760735484
Name:SCHNEIDER, MICHELLE RAE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RAE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 PAULSON RD
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-8299
Mailing Address - Country:US
Mailing Address - Phone:715-425-5256
Mailing Address - Fax:
Practice Address - Street 1:1777 PAULSON RD
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-8299
Practice Address - Country:US
Practice Address - Phone:715-425-5256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14100-040183500000X
TX37067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist