1457800070 NPI number — MRS. CAYLA ELIZABETH SCHNIDER PA-C

Table of content: MRS. CAYLA ELIZABETH SCHNIDER PA-C (NPI 1457800070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457800070 NPI number — MRS. CAYLA ELIZABETH SCHNIDER PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNIDER
Provider First Name:
CAYLA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BEST
Provider Other First Name:
CAYLA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457800070
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 749495
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30374-9495
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-963-2100
Provider Business Mailing Address Fax Number:
813-321-1296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 1ST ST
Provider Second Line Business Practice Location Address:
SUITE 410
Provider Business Practice Location Address City Name:
MACON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31201-8300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-743-7068
Provider Business Practice Location Address Fax Number:
478-741-1354
Provider Enumeration Date:
09/23/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  8018 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 003182953A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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