Provider Demographics
NPI:1902526122
Name:TSCHAKERT, SHAYLA JO (PA)
Entity type:Individual
Prefix:MRS
First Name:SHAYLA
Middle Name:JO
Last Name:TSCHAKERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SHAYLA
Other - Middle Name:JO
Other - Last Name:STEINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-3709
Mailing Address - Country:US
Mailing Address - Phone:715-395-5393
Mailing Address - Fax:715-392-1935
Practice Address - Street 1:202 ARBOR CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-1727
Practice Address - Country:US
Practice Address - Phone:612-281-4606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA117713363A00000X
NE2857363A00000X
MN1009363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant