Provider Demographics
NPI:1730513680
Name:SCHOONOVER, RAYANNE LICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:RAYANNE
Middle Name:LICHELLE
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RAYANNE
Other - Middle Name:LICHELLE
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:86 GENESEE STREET
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413
Mailing Address - Country:US
Mailing Address - Phone:315-732-7909
Mailing Address - Fax:315-793-9307
Practice Address - Street 1:86 GENESEE STREET
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2389
Practice Address - Country:US
Practice Address - Phone:315-732-7909
Practice Address - Fax:315-793-9307
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03688502Medicaid