MEDICARE: MS. JACQUELINE ANN SCHNEIDER RNC ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	573546	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8N7192	OTHER	TX	BCBS TX
2	RN573546	OTHER	TX	RN LICENSE

General Provider Information

NPI Number	:	1538111430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JACQUELINE ANN SCHNEIDER RNC ANP

Provider Business Mailing Address
First Line	:	7 BUTTERFLY LN
Second Line	:
City	:	WIMBERLEY
State	:	TX
Zip	:	78676
Country	:	US
Telephone Number	:	512-847-8744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 W BEN WHITE BLVD STE 100B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7667
Country	:	US
Telephone Number	:	512-440-1441
Fax Number	:	512-440-1448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/08/2007

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