Provider Demographics
NPI:1528893435
Name:SCHNECK, KAY LYNN
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:LYNN
Last Name:SCHNECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 W BUTLER DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-8057
Mailing Address - Country:US
Mailing Address - Phone:623-412-4703
Mailing Address - Fax:
Practice Address - Street 1:8540 W BUTLER DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-8057
Practice Address - Country:US
Practice Address - Phone:623-412-4703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI195518-30163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool