Provider Demographics
NPI:1952635864
Name:SCHNEIDER, HOLLY A (FNP-BC, APNP, RN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:FNP-BC, APNP, RN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:A
Other - Last Name:WESTPHAL SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:800-326-2250
Mailing Address - Fax:
Practice Address - Street 1:215 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-1700
Practice Address - Country:US
Practice Address - Phone:262-375-3700
Practice Address - Fax:262-376-6032
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI126317-030363LF0000X
WI3869-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1952635864Medicaid
WI100009018Medicaid
WI1952635864OtherNPI
WI1952635864Medicaid