Provider Demographics
NPI:1568086205
Name:SCHATTSCHNEIDER, BERGEN NICOLE (PA)
Entity type:Individual
Prefix:
First Name:BERGEN
Middle Name:NICOLE
Last Name:SCHATTSCHNEIDER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BERGEN
Other - Middle Name:NICOLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2355
Mailing Address - Country:US
Mailing Address - Phone:515-248-1447
Mailing Address - Fax:515-248-1440
Practice Address - Street 1:3510 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-8533
Practice Address - Country:US
Practice Address - Phone:515-232-0628
Practice Address - Fax:515-232-0727
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA105195363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant