Provider Demographics
NPI:1457248460
Name:SCHNUELLE, BRIANNA MAXINE (WHGRNP-BC AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MAXINE
Last Name:SCHNUELLE
Suffix:
Gender:F
Credentials:WHGRNP-BC AGPCNP-BC
Other - Prefix:MRS
Other - First Name:BRIANNA
Other - Middle Name:MAXINE
Other - Last Name:SCHNUELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BRIANNA MAXINE RADAJ
Mailing Address - Street 1:N7683 LAKESHORE RD
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53083-5317
Mailing Address - Country:US
Mailing Address - Phone:920-664-3798
Mailing Address - Fax:
Practice Address - Street 1:3680 NW SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3737
Practice Address - Country:US
Practice Address - Phone:541-754-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1119898-30163W00000X
ORAPPLYING363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse