Healthcare Provider Details

I. General information

NPI: 1285969907
Provider Name (Legal Business Name): ELISABBATH B SCHRADER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SABBATH SCHRADER RN

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 01/07/2023
Certification Date: 01/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4123 UNIVERSITY AVE
DES MOINES IA
50311-3532
US

IV. Provider business mailing address

730 36TH ST
DES MOINES IA
50312-3218
US

V. Phone/Fax

Practice location:
  • Phone: 515-303-0661
  • Fax:
Mailing address:
  • Phone: 515-779-9033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number132139
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: