Healthcare Provider Details

I. General information

NPI: 1255113593
Provider Name (Legal Business Name): RAECHEL SCHOWALTER MSN-ED, RN, AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W CHAMBERS ST # 1150F
MILWAUKEE WI
53210-1650
US

IV. Provider business mailing address

5000 W CHAMBERS ST # 1150F
MILWAUKEE WI
53210-1650
US

V. Phone/Fax

Practice location:
  • Phone: 414-874-4902
  • Fax:
Mailing address:
  • Phone: 414-874-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number109375-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: