Provider Demographics
NPI:1356807242
Name:SCHLEIFFELDER, JUSTINE MARIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:MARIE
Last Name:SCHLEIFFELDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:JUSTINE
Other - Middle Name:MARIE
Other - Last Name:SCHLEIFFELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:803-935-8292
Mailing Address - Fax:
Practice Address - Street 1:1526 LAKE MURRAY BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-8622
Practice Address - Country:US
Practice Address - Phone:803-749-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25869363LF0000X
NYF343487-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily