Healthcare Provider Details

I. General information

NPI: 1679643522
Provider Name (Legal Business Name): SANDRA FAYE SCHLETER APRN BC CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8085 WAYZATA BLVD SUITE 101 BHSI LLC
GOLDEN VALLEY MN
55426-1456
US

IV. Provider business mailing address

2497 7TH AVE E SUITE 101 BHSI LLC
NORTH ST PAUL MN
55109-2496
US

V. Phone/Fax

Practice location:
  • Phone: 651-769-6300
  • Fax: 651-769-6349
Mailing address:
  • Phone: 651-769-6437
  • Fax: 651-769-6426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR1288533
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: