MEDICARE: MRS. GRACE DILLEHAY SCHNEIDER MSN, APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0034057	OH

General Provider Information

NPI Number	:	1578247391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GRACE DILLEHAY SCHNEIDER MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	11121 NORTHWOOD AVE NE
Second Line	:
City	:	BOLIVAR
State	:	OH
Zip	:	44612-8623
Country	:	US
Telephone Number	:	740-358-2016
Fax Number	:

Provider Business Practice Location Address
First Line	:	4320 CLEVELAND AVE S
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-1143
Country	:	US
Telephone Number	:	740-358-2016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2023
Last Update Date	:	06/12/2023

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