Provider Demographics
NPI:1841773017
Name:SCHACHER, JOANN MAVIS
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:MAVIS
Last Name:SCHACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56549-4428
Mailing Address - Country:US
Mailing Address - Phone:701-866-7730
Mailing Address - Fax:
Practice Address - Street 1:1100 13TH AVE E
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3376
Practice Address - Country:US
Practice Address - Phone:701-281-5695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRN22206163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse