Provider Demographics
NPI:1154798726
Name:SCHAUB, JENNIFER LYN (STNA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYN
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYN
Other - Last Name:STAFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:1528 BUNKER DR
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3851
Mailing Address - Country:US
Mailing Address - Phone:416-679-0276
Mailing Address - Fax:
Practice Address - Street 1:1528 BUNKER DR
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-3851
Practice Address - Country:US
Practice Address - Phone:416-679-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-30
Last Update Date:2015-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH378503180999376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide