Provider Demographics
NPI:1992135479
Name:SCHAEFER, BERYL STEPHANIE
Entity type:Individual
Prefix:MS
First Name:BERYL
Middle Name:STEPHANIE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BERYL
Other - Middle Name:STEPHANIE
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8031 CAMPUS DELIVERY
Mailing Address - Street 2:CSU HEALTH NETWORK
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80523-8031
Mailing Address - Country:US
Mailing Address - Phone:970-491-1734
Mailing Address - Fax:970-491-4158
Practice Address - Street 1:CSU HEALTH NETWORK 8031 CAMPUS DELIVERY
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-8031
Practice Address - Country:US
Practice Address - Phone:970-491-1734
Practice Address - Fax:970-491-4158
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO163WP0809X163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86349OtherRN LICENSE