Provider Demographics
NPI:1124319322
Name:SCHAEFER, ZOE ANNE (ARNP)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:ANNE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-4396
Mailing Address - Country:US
Mailing Address - Phone:319-292-2413
Mailing Address - Fax:319-433-2799
Practice Address - Street 1:425 E RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5043
Practice Address - Country:US
Practice Address - Phone:319-433-2780
Practice Address - Fax:319-433-2799
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-070419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1689799801OtherSUCCESS STREET