Healthcare Provider Details

I. General information

NPI: 1992080535
Provider Name (Legal Business Name): KENDRA K SCHROEDER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LINCOLN CIR SE
ORANGE CITY IA
51041-1836
US

IV. Provider business mailing address

1000 LINCOLN CIR SE
ORANGE CITY IA
51041-1836
US

V. Phone/Fax

Practice location:
  • Phone: 712-737-4984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA-068276
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License NumberA068276
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberA068276
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: