Provider Demographics
NPI:1801846688
Name:SCHNEIDER, JULIE LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 KENYON RD, STE A
Mailing Address - Street 2:PHYSICIAN'S OFFICE BUILDING, WEST
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5742
Mailing Address - Country:US
Mailing Address - Phone:515-574-6120
Mailing Address - Fax:515-574-6135
Practice Address - Street 1:804 KENYON RD, STE A
Practice Address - Street 2:PHYSICIAN'S OFFICE BUILDING, WEST
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5742
Practice Address - Country:US
Practice Address - Phone:515-574-6120
Practice Address - Fax:515-574-6135
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT104919363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0425041Medicaid
IA43945OtherBLUE CROSS BLUE SHIELD
IA0425041Medicaid
IA43945OtherBLUE CROSS BLUE SHIELD