Healthcare Provider Details

I. General information

NPI: 1316029630
Provider Name (Legal Business Name): KELLIE S. TOTH PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLIE LYNN SCHNEIDER PA-C

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8573 COUNTY ROAD 64
DAPHNE AL
36526-8706
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 251-621-2244
  • Fax: 251-621-7209
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-460
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.460
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: