Provider Demographics
NPI:1013311380
Name:SCHREURS, SHANNA LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:LYNN
Last Name:SCHREURS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:LYNN
Other - Last Name:GRANBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:10725 DOUBLE R BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8973
Mailing Address - Country:US
Mailing Address - Phone:775-800-1988
Mailing Address - Fax:775-525-3357
Practice Address - Street 1:10725 DOUBLE R BLVD STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8973
Practice Address - Country:US
Practice Address - Phone:775-800-1988
Practice Address - Fax:775-525-3357
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001861363LP0808X, 363L00000X
NVRN65758163W00000X
TX791775163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV12774102OtherCAQH
NVAPRN001861OtherAPRN LICENSE
NV12774102OtherCAQH