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NPI 1700184009

NPI 1700184009 : MARY C SCHROEDER PMHCNS : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1700184009
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    Entity Type          |    Individual 
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    Provider Name        |    MARY C SCHROEDER PMHCNS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/10/2011
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    Last Update Date     |    03/10/2011
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Provider Practice Location Address
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    Address Line         |    4040 W 86TH ST 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46268-7800
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    Country              |    US
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    Telephone            |    317-876-3699
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    Fax                  |    317-876-3600
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Provider Business Mailing Address
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    Address Line         |    8816 HOLLIDAY DR 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46260-1706
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    Country              |    US
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    Telephone            |    317-218-3602
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    364SP0809X
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    Taxonomy Name        |    Adult Psychiatric/Mental Health Clinical Nurse Specialist
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    License Number       |    28070089A
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    License Number State |    IN
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