Provider Demographics
NPI:1801131644
Name:SCHRAUBEN, CODI M (ANP-BC)
Entity type:Individual
Prefix:MS
First Name:CODI
Middle Name:M
Last Name:SCHRAUBEN
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MISS
Other - First Name:CODI
Other - Middle Name:MICHELLE
Other - Last Name:FINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 ROSEHILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-1762
Mailing Address - Country:US
Mailing Address - Phone:517-212-2008
Mailing Address - Fax:517-212-2009
Practice Address - Street 1:4760 FASHION SQUARE BLVD STE L-1
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2620
Practice Address - Country:US
Practice Address - Phone:989-282-4003
Practice Address - Fax:888-491-7220
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704268903363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health