Provider Demographics
NPI:1407961493
Name:SCHREINER, LOIS L (PA - C)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:L
Last Name:SCHREINER
Suffix:
Gender:
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:OK
Mailing Address - Zip Code:73728-2545
Mailing Address - Country:US
Mailing Address - Phone:580-596-2800
Mailing Address - Fax:580-596-2805
Practice Address - Street 1:405 S OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:OK
Practice Address - Zip Code:73728-2545
Practice Address - Country:US
Practice Address - Phone:580-596-2800
Practice Address - Fax:580-596-2805
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1501099363AM0700X
OK4978363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200347020AMedicaid
KS426895Medicare ID - Type UnspecifiedCLINIC PROVIDER BILLING #