Provider Demographics
NPI:1023585973
Name:SCHADEWALD, CRAIG ALAN (FNP-C)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:SCHADEWALD
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 MEDICAL GROUP
Mailing Address - Street 2:7219 N LITCHFIELD RD
Mailing Address - City:LUKE AFB
Mailing Address - State:AZ
Mailing Address - Zip Code:85309
Mailing Address - Country:US
Mailing Address - Phone:623-856-2273
Mailing Address - Fax:
Practice Address - Street 1:56 MEDICAL GROUP
Practice Address - Street 2:7219 N LITCHFIELD RD
Practice Address - City:LUKE AFB
Practice Address - State:AZ
Practice Address - Zip Code:85309
Practice Address - Country:US
Practice Address - Phone:623-856-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9399165163WM0705X
AZ259666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical