Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 1500 | CA |
N | 363LC1500X | Nurse Practitioner - Community Health | 1500 | CA |
NPI | 1730567454 |
---|---|
Provider Name | Antonia Schaeffer |
First Address | Placerville, CA 95667-8710 |
Second Address | Auburn, CA 95630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 14/05/2015 |