Provider Demographics
NPI:1952773996
Name:SCHENEWERK, AUDREY (ND)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:
Last Name:SCHENEWERK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:AUDREY
Other - Middle Name:ROSE
Other - Last Name:SCHENEWERK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:1041 GRAND AVE # 138
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3002
Mailing Address - Country:US
Mailing Address - Phone:651-447-7200
Mailing Address - Fax:800-886-1104
Practice Address - Street 1:11791 W 112TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210
Practice Address - Country:US
Practice Address - Phone:913-214-6536
Practice Address - Fax:913-214-6539
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1128175F00000X
MTAHC-NAT-LIC-1293175F00000X
WI6003-170175F00000X
KS21-00053175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath