Provider Demographics
NPI:1932437548
Name:SCHWEDER, STACI LYNN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:STACI
Middle Name:LYNN
Last Name:SCHWEDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746870
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6870
Mailing Address - Country:US
Mailing Address - Phone:469-727-6675
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:215 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-4403
Practice Address - Country:US
Practice Address - Phone:515-666-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily