Provider Demographics
NPI:1790793420
Name:SCHABERT, CINDY MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:MARIE
Last Name:SCHABERT
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SMITH AVE N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2572
Mailing Address - Country:US
Mailing Address - Phone:651-292-0616
Mailing Address - Fax:
Practice Address - Street 1:255 SMITH AVE N
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2572
Practice Address - Country:US
Practice Address - Phone:651-292-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 081465-2363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43993000Medicaid
MNP72472Medicare UPIN