Healthcare Provider Details

I. General information

NPI: 1245416502
Provider Name (Legal Business Name): LYNN S SCHNAUTZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN P SMITH NP

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 GATEWAY BLVD
NEWBURGH IN
47630-8947
US

IV. Provider business mailing address

PO BOX 1230
EVANSVILLE IN
47706-1230
US

V. Phone/Fax

Practice location:
  • Phone: 812-842-4784
  • Fax: 812-842-3921
Mailing address:
  • Phone: 812-464-9133
  • Fax: 812-464-0559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002563A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71002563A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: