Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 2019030586 | MO |
N | 363LN0000X | Nurse Practitioner - Neonatal | 25226 | TN |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 25226 | TN |
NPI | 1316418916 |
---|---|
Provider Name | Ms. Whitney Rae Schmale |
First Address | Waterloo, IL 62298-4402 |
Second Address | Saint Louis, MO 63110-1002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2018 |
Last Update Date | 02/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2019030586 | MO BOARD OF NURSING (01) | MO |
25226 | TN BOARD OF NURSING (01) | TN |