Healthcare Provider Details

I. General information

NPI: 1992165666
Provider Name (Legal Business Name): MICHELE SCHRODER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EDEN AVE
CINCINNATI OH
45219-4231
US

IV. Provider business mailing address

200 EDEN AVE
CINCINNATI OH
45219-4231
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8523
  • Fax: 513-475-7327
Mailing address:
  • Phone: 513-475-8523
  • Fax: 513-475-7327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18809
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: