Provider Demographics
NPI:1801293436
Name:SCHNEITMAN, JODIE L (AG-ACNP, BC)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:L
Last Name:SCHNEITMAN
Suffix:
Gender:F
Credentials:AG-ACNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MCFARLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3977
Mailing Address - Country:US
Mailing Address - Phone:423-492-5450
Mailing Address - Fax:865-374-2095
Practice Address - Street 1:705 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3977
Practice Address - Country:US
Practice Address - Phone:423-492-5450
Practice Address - Fax:865-374-2095
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19350363LA2200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN19350OtherAPN LISCENSE
TNQ011449Medicaid