Healthcare Provider Details

I. General information

NPI: 1154215317
Provider Name (Legal Business Name): KELLY SCHOENBACHLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 S FLOYD ST
LOUISVILLE KY
40202-1840
US

IV. Provider business mailing address

6403 WHISPERING WAY
CHARLESTOWN IN
47111-8706
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number28160537C
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: