Basic Information
| Provider Information | |||||||||
| NPI: | 1508968348 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHNIEDER | ||||||||
| FirstName: | GAIL | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | CNS, CDE, CWOCN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1230 E MAIN ST | ||||||||
| Address2: | PO BOX 8674 | ||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560015066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5076251811 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1230 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560015066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5076251811 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2006 | ||||||||
| LastUpdateDate: | 09/04/2008 | ||||||||
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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 | 364SG0600X | R0523299 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Gerontology |
ID Information
| ID | Type | State | Issuer | Description | 265N4SC | 01 | MN | BCBSM | OTHER | 901470500 | 05 | MN | MEDICAID | P00602858 | 01 | MN | RR MEDICARE | OTHER |