Provider Demographics
NPI:1144096892
Name:SCHOONOVER, ANGELA JEAN (LPN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JEAN
Last Name:SCHOONOVER
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 1:365 BIG CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-9629
Mailing Address - Country:US
Mailing Address - Phone:360-632-6841
Mailing Address - Fax:
Practice Address - Street 1:365 BIG CEDAR LN
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-9629
Practice Address - Country:US
Practice Address - Phone:360-632-6841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00051747164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse