Provider Demographics
NPI:1316119902
Name:SCHLUETER, MARY GAUGHRAN (RN, MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:GAUGHRAN
Last Name:SCHLUETER
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 PAULETTE PL
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2729
Mailing Address - Country:US
Mailing Address - Phone:818-790-2317
Mailing Address - Fax:
Practice Address - Street 1:421 PAULETTE PL
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-2729
Practice Address - Country:US
Practice Address - Phone:818-790-2317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA281002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily