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General NPI Number Information
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NPI Number | 1871537134
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Entity Type | Individual
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Provider Name | KELLY M SCHEDER NP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 206 N MILL ST
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City | LA FARGE
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State | WI
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Zip | 54639-6601
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Country | US
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Telephone | 608-625-2494
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Fax | 608-638-5011
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Provider Business Mailing Address
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Address Line | 206 N MILL ST
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City | LA FARGE
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State | WI
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Zip | 54639-6601
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Country | US
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Telephone | 608-625-2494
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Fax | 608-638-5011
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2454
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License Number State | WI
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