MEDICARE: PEGGY ANN SCHLOMER RNFA

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	163W00000X	Registered Nurse	119373	CO
2	163WR0006X	Registered Nurse First Assistant	1546	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790044667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY ANN SCHLOMER RNFA

Provider Business Mailing Address
First Line	:	1107 S LEMAY AVE
Second Line	:	STE 240
City	:	FORT COLLINS
State	:	CO
Zip	:	80524
Country	:	US
Telephone Number	:	970-495-7421
Fax Number	:	970-495-7424

Provider Business Practice Location Address
First Line	:	1107 S LEMAY AVE
Second Line	:	STE 240
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3960
Country	:	US
Telephone Number	:	970-495-7421
Fax Number	:	970-495-7424

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

Provider Enumeration Date	:	05/11/2012
Last Update Date	:	01/20/2015

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