Provider Demographics
NPI:1124123294
Name:SCHANKE, ANNE MARIE (RD LD N)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:SCHANKE
Suffix:
Gender:F
Credentials:RD LD N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20889 MORADA CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1714
Mailing Address - Country:US
Mailing Address - Phone:561-445-7648
Mailing Address - Fax:561-487-5479
Practice Address - Street 1:20889 MORADA CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-1714
Practice Address - Country:US
Practice Address - Phone:561-445-7648
Practice Address - Fax:561-487-5479
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2010-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3246133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN0184OtherBLUE CROSS BLUE SHIELD
FLE7438Medicare PIN