Healthcare Provider Details

I. General information

NPI: 1093536450
Provider Name (Legal Business Name): TEGAN SCHNEIDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 UNIVERSITY AVE
DUBUQUE IA
52001-5050
US

IV. Provider business mailing address

14674 W MOUNTAIN VIEW BLVD STE 200
SURPRISE AZ
85374-2708
US

V. Phone/Fax

Practice location:
  • Phone: 563-589-3662
  • Fax:
Mailing address:
  • Phone: 623-544-6860
  • Fax: 623-544-6861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number11531
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: