Healthcare Provider Details

I. General information

NPI: 1407817059
Provider Name (Legal Business Name): TERRY R SCHREIBER C.R.N.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/13/2026
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 SOUTHPARK CIR E
ST AUGUSTINE FL
32086-5135
US

IV. Provider business mailing address

40 GROOVER LOOP
ST AUGUSTINE FL
32086-6564
US

V. Phone/Fax

Practice location:
  • Phone: 904-824-6108
  • Fax: 904-823-9613
Mailing address:
  • Phone: 904-824-6108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1859492
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: