MEDICARE: ZOE SCHROEDER MS, RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	86072380	AZ

General Provider Information

NPI Number	:	1104435775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZOE SCHROEDER MS, RDN

Provider Business Mailing Address
First Line	:	5031 E FAIRMOUNT ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-4060
Country	:	US
Telephone Number	:	928-202-7709
Fax Number	:

Provider Business Practice Location Address
First Line	:	5031 E FAIRMOUNT ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-4060
Country	:	US
Telephone Number	:	928-202-7709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2020
Last Update Date	:	07/29/2020

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