Provider Demographics
NPI:1801042759
Name:SCHNEIDER, KATHRYN M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:M
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:819 WORCESTER ST
Mailing Address - Street 2:STE 3
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01151-1045
Mailing Address - Country:US
Mailing Address - Phone:413-543-6820
Mailing Address - Fax:413-543-7962
Practice Address - Street 1:365 MONTAUK AVE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4700
Practice Address - Country:US
Practice Address - Phone:860-271-4364
Practice Address - Fax:860-444-5114
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT005346363LF0000X
CT5346363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily