Provider Demographics
NPI:1699103358
Name:SCHWANKE, ANNEMARIE (APRN, CNM)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:SCHWANKE
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:KASSON
Mailing Address - State:MN
Mailing Address - Zip Code:55944-2943
Mailing Address - Country:US
Mailing Address - Phone:507-634-6071
Mailing Address - Fax:
Practice Address - Street 1:603 3RD ST SE
Practice Address - Street 2:
Practice Address - City:KASSON
Practice Address - State:MN
Practice Address - Zip Code:55944-2943
Practice Address - Country:US
Practice Address - Phone:507-634-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNM0858176B00000X
MN0010367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1699103358Medicaid