Healthcare Provider Details

I. General information

NPI: 1083772859
Provider Name (Legal Business Name): SUSANNE W. SCHNEIDER RNCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HOWARD ST
FRAMINGHAM MA
01702-8313
US

IV. Provider business mailing address

135 SCHOOL ST
WAYLAND MA
01778-4548
US

V. Phone/Fax

Practice location:
  • Phone: 508-879-2250
  • Fax: 508-620-2637
Mailing address:
  • Phone: 508-655-4159
  • Fax: 508-620-2637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number85394
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: