Healthcare Provider Details

I. General information

NPI: 1215488846
Provider Name (Legal Business Name): RONIE RAYE SCHAFER APN-RXN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 08/11/2023
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 RUSH DR
SALIDA CO
81201-9627
US

IV. Provider business mailing address

3829 PUEBLO ST
EVANS CO
80620-2728
US

V. Phone/Fax

Practice location:
  • Phone: 719-530-2033
  • Fax:
Mailing address:
  • Phone: 970-397-0779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0179775
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0992916-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: