Provider Demographics
NPI:1700176765
Name:SCHAUFELBERGER, VERONICA LYNN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:LYNN
Last Name:SCHAUFELBERGER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:LYNN
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:650 W TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-1227
Mailing Address - Country:US
Mailing Address - Phone:618-283-5444
Mailing Address - Fax:618-283-1617
Practice Address - Street 1:825 NEW YORK DR
Practice Address - Street 2:SUITE 2
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-1044
Practice Address - Country:US
Practice Address - Phone:618-283-5545
Practice Address - Fax:618-283-2951
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily