Provider Demographics
NPI:1497794085
Name:SCHATZ, WYNELL CARTER (CRNA)
Entity type:Individual
Prefix:
First Name:WYNELL
Middle Name:CARTER
Last Name:SCHATZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:WYNELL
Other - Middle Name:MARIE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 3297
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-2497
Mailing Address - Country:US
Mailing Address - Phone:540-662-8336
Mailing Address - Fax:540-662-8593
Practice Address - Street 1:1000 N SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3598
Practice Address - Country:US
Practice Address - Phone:540-635-0219
Practice Address - Fax:540-635-0427
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK25741367500000X
VA0024164780367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497794085Medicaid
VA430001569Medicare PIN
VAVV7017AMedicare PIN