Healthcare Provider Details

I. General information

NPI: 1982569554
Provider Name (Legal Business Name): JILL SCHRAMEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 11TH AVE
DETROIT LAKES MN
56501-2800
US

IV. Provider business mailing address

2176 SHADY LN
DETROIT LAKES MN
56501-4830
US

V. Phone/Fax

Practice location:
  • Phone: 218-847-1106
  • Fax:
Mailing address:
  • Phone: 218-329-2314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number09147844
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: