Basic Information
Provider Information
NPI: 1265819049
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHAUB
FirstName: ERIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 JOHN ST
Address2: SUITE N1200
City: KALAMAZOO
State: MI
PostalCode: 490075341
CountryCode: US
TelephoneNumber: 2693417979
FaxNumber: 2693416261
Practice Location
Address1: 601 JOHN ST
Address2: SUITE N1200
City: KALAMAZOO
State: MI
PostalCode: 490075341
CountryCode: US
TelephoneNumber: 2693417979
FaxNumber: 2693416261
Other Information
ProviderEnumerationDate: 04/30/2015
LastUpdateDate: 10/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X4704288271MIY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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