Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | SP010322 | PA |
NPI | 1073741542 |
---|---|
Provider Name | Mrs. Prudence Lyn Schuchart |
First Address | Lemoyne, PA 17043-1230 |
Second Address | Lemoyne, PA 17043-1230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 23/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1328102 | COVENTRY HEALTH AMERICA (01) | PA |
2117428 | HIGHMARK BLUE SHIELD (01) | PA |
50107812 | CAPITAL BLUE CROSS (01) | PA |