Provider Demographics
NPI:1891198578
Name:SCHAALE, ANDREA CAROLINA (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CAROLINA
Last Name:SCHAALE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:MARRUGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4100 CENTRAL PIKE APT 1419
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3266
Mailing Address - Country:US
Mailing Address - Phone:305-490-9906
Mailing Address - Fax:
Practice Address - Street 1:438 N WATER AVE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2306
Practice Address - Country:US
Practice Address - Phone:615-306-3092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2634363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical