Provider Demographics
NPI:1902485949
Name:SCHNEIDER, CATHERINE ANN (RN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10828 W FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HANNA CITY
Mailing Address - State:IL
Mailing Address - Zip Code:61536-9430
Mailing Address - Country:US
Mailing Address - Phone:309-222-0196
Mailing Address - Fax:
Practice Address - Street 1:9211 N TRIGGER RD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:IL
Practice Address - Zip Code:61528-9618
Practice Address - Country:US
Practice Address - Phone:309-966-1558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-265573163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041-265573OtherREGISTERED NURSE