Healthcare Provider Details

I. General information

NPI: 1386571354
Provider Name (Legal Business Name): STEPHANIE LYNN SCHAFER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5498 109TH AVE
PULLMAN MI
49450-9631
US

IV. Provider business mailing address

497 CENTER ST
DOUGLAS MI
49406-5130
US

V. Phone/Fax

Practice location:
  • Phone: 269-427-7937
  • Fax:
Mailing address:
  • Phone: 269-302-2008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2902021501
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: