Provider Demographics
NPI:1366704025
Name:SCHNAUBELT, CHARLES J (MSN ACNP-BC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:SCHNAUBELT
Suffix:
Gender:M
Credentials:MSN ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 HAMILTON ST STE 308
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6359
Mailing Address - Country:US
Mailing Address - Phone:610-481-9600
Mailing Address - Fax:610-481-0225
Practice Address - Street 1:2200 HAMILTON ST STE 308
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6359
Practice Address - Country:US
Practice Address - Phone:610-481-9600
Practice Address - Fax:610-481-0225
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012270363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032548690002Medicaid