Healthcare Provider Details

I. General information

NPI: 1306182662
Provider Name (Legal Business Name): KATHERINE RUTH SCHNEIDER C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE RUTH FETTER

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 RENAISSANCE CTR STE 2600
DETROIT MI
48243-1599
US

IV. Provider business mailing address

126 STEINMETZ RD
SCHWENKSVILLE PA
19473-1457
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 484-459-2797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP012641
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: