Healthcare Provider Details

I. General information

NPI: 1174692321
Provider Name (Legal Business Name): KAREN LANE SCHROEDER CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 SE 7TH ST
BOYNTON BEACH FL
33435-5785
US

IV. Provider business mailing address

848 SE 7TH ST
BOYNTON BEACH FL
33435-5785
US

V. Phone/Fax

Practice location:
  • Phone: 561-212-9277
  • Fax: 561-739-6020
Mailing address:
  • Phone: 561-212-9277
  • Fax: 561-739-6020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number1853532
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: