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Individual
JENNIFER L SCHOTTLEUTNER
Active
Individual
JENNIFER L SCHOTTLEUTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1408
SC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0794PA
—
SC
01
—
P00761341
RAILROAD MEDICARE
SC
Enumeration date
03/23/2009
Last updated
12/10/2009
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