Healthcare Provider Details

I. General information

NPI: 1174619191
Provider Name (Legal Business Name): LORETTA B SCHAAF BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 FOLKER STREET
ANKORAGE AK
99508
US

IV. Provider business mailing address

8050 PIONEER #205
ANCHORAGE AK
99504-4755
US

V. Phone/Fax

Practice location:
  • Phone: 907-261-5551
  • Fax:
Mailing address:
  • Phone: 907-677-6038
  • Fax: 907-561-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number19608
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: