Provider Demographics
NPI:1780686378
Name:SCHNOBRICH, MARGARET RADERMACHER (CRNA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:RADERMACHER
Last Name:SCHNOBRICH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:RADERMACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:10332 ABBOTT DR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1324
Mailing Address - Country:US
Mailing Address - Phone:763-315-8876
Mailing Address - Fax:
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-8000
Practice Address - Fax:651-254-8024
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 115057-7367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN07A23RAOtherBCBSMN
MN428017200Medicaid
MN428017200Medicaid