Provider Demographics
NPI:1245946284
Name:SCHNEIDER, KRISTINA JENNIFER
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:JENNIFER
Last Name:SCHNEIDER
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 1:735 ENGLISH DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-1627
Mailing Address - Country:US
Mailing Address - Phone:307-235-4956
Mailing Address - Fax:
Practice Address - Street 1:735 ENGLISH DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1627
Practice Address - Country:US
Practice Address - Phone:307-235-4956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYHLTH-00052-2023225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist