Healthcare Provider Details

I. General information

NPI: 1275153108
Provider Name (Legal Business Name): KATRINA ELISE SCHLEENVOIGT LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 COMMERCE AVE
CULLMAN AL
35055-6151
US

IV. Provider business mailing address

1131 EAGLETREE LN SW STE 300
HUNTSVILLE AL
35801-6496
US

V. Phone/Fax

Practice location:
  • Phone: 256-734-4688
  • Fax:
Mailing address:
  • Phone: 256-533-1970
  • Fax: 256-532-4112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-184441
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier330000014
Identifier TypeMEDICAID
Identifier StateAL
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: