Healthcare Provider Details

I. General information

NPI: 1609764539
Provider Name (Legal Business Name): GWENDOLYN STARR SCHROEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 SPRING VALLEY RD
LANCASTER PA
17601-2443
US

IV. Provider business mailing address

2195 SPRING VALLEY RD
LANCASTER PA
17601-2443
US

V. Phone/Fax

Practice location:
  • Phone: 717-406-7201
  • Fax: 717-406-7201
Mailing address:
  • Phone: 717-406-7201
  • Fax: 717-406-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN626249
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN626249
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: