Healthcare Provider Details

I. General information

NPI: 1891832200
Provider Name (Legal Business Name): CARLA R SCHEPER RN, CNOR, CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 SHADY BROOK DR
CAPE GIRARDEAU MO
63701-9307
US

IV. Provider business mailing address

456 SHADY BROOK DR
CAPE GIRARDEAU MO
63701-9307
US

V. Phone/Fax

Practice location:
  • Phone: 573-243-2263
  • Fax: 573-243-0212
Mailing address:
  • Phone: 573-243-2263
  • Fax: 573-243-0212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number067128
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: