Healthcare Provider Details

I. General information

NPI: 1780892059
Provider Name (Legal Business Name): JENNIFER STEWART SCHNEIDER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2007
Last Update Date: 07/21/2022
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 WYOMING BLVD NE STE F1
ALBUQUERQUE NM
87109-3983
US

IV. Provider business mailing address

7007 WYOMING BLVD NE STE F1
ALBUQUERQUE NM
87109-3983
US

V. Phone/Fax

Practice location:
  • Phone: 505-807-3086
  • Fax: 505-807-3086
Mailing address:
  • Phone: 505-807-3086
  • Fax: 505-807-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401702-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP-03262
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: