Basic Information
| Provider Information | |||||||||
| NPI: | 1588300602 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SCHWADERER | ||||||||
| FirstName: | PAXTON | ||||||||
| MiddleName: | N. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 N COLUMBUS ST | ||||||||
| Address2: | |||||||||
| City: | CRESTLINE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448271455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194623485 | ||||||||
| FaxNumber: | 4194624582 | ||||||||
| Practice Location | |||||||||
| Address1: | 269 PORTLAND WAY S | ||||||||
| Address2: | |||||||||
| City: | GALION | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448332312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194684841 | ||||||||
| FaxNumber: | 4194682381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2022 | ||||||||
| LastUpdateDate: | 05/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | APRN.CRNA.0020522 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.