Healthcare Provider Details

I. General information

NPI: 1851411441
Provider Name (Legal Business Name): BARBARA SUE SCHOONOVER RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S NATIONAL AVE
SPRINGFIELD MO
65807-5210
US

IV. Provider business mailing address

1423 N JEFFERSON AVE
SPRINGFIELD MO
65802-1917
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-5116
  • Fax: 417-269-4265
Mailing address:
  • Phone: 417-269-3900
  • Fax: 417-269-8260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number054765
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: