Provider Demographics
NPI:1750561098
Name:SCHOEN, KELLY L (LPN)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:L
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3970 96TH ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5757
Mailing Address - Country:US
Mailing Address - Phone:715-723-0549
Mailing Address - Fax:715-723-0549
Practice Address - Street 1:3970 96TH ST
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-5757
Practice Address - Country:US
Practice Address - Phone:715-723-0549
Practice Address - Fax:715-723-0549
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse