Provider Demographics
NPI:1255748349
Name:SCHATZ, STEPHANIE LAUREN (MSN, RN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LAUREN
Last Name:SCHATZ
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 KILLDEER LANE
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:MO
Mailing Address - Zip Code:63080
Mailing Address - Country:US
Mailing Address - Phone:573-259-3598
Mailing Address - Fax:
Practice Address - Street 1:102 GRANDE CTR
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:MO
Practice Address - Zip Code:63080-1266
Practice Address - Country:US
Practice Address - Phone:573-468-4455
Practice Address - Fax:573-468-4451
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014023966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2010034841OtherMISSOURI RN LICENSE
MO2014023966OtherMISSOURI CNP LICENSE