Basic Information
| Provider Information | |||||||||
| NPI: | 1235512310 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHACHERL | ||||||||
| FirstName: | CARRI | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 190 GRAND SEASONS DR | ||||||||
| Address2: | |||||||||
| City: | WAUPACA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549818219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152583650 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 190 GRAND SEASONS DR | ||||||||
| Address2: | |||||||||
| City: | WAUPACA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549818219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152583650 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2015 | ||||||||
| LastUpdateDate: | 09/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 6435 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 120653 | 01 | WI | RN LIC | OTHER |