Healthcare Provider Details

I. General information

NPI: 1396090031
Provider Name (Legal Business Name): TRENT CHARLES SCHROETLIN EMT INTERMEDIATE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 HOSPITAL ROAD
SCHURZ NV
89427-0502
US

IV. Provider business mailing address

222 FERNWOOD DR
FERNLEY NV
89408-7624
US

V. Phone/Fax

Practice location:
  • Phone: 775-773-2377
  • Fax:
Mailing address:
  • Phone: 775-773-2377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number16349
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: