MEDICARE: JASMINE SCHRADER

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	174N00000X	Lactation Consultant (Non-RN)
2	374J00000X	Doula

General Provider Information

NPI Number	:	1629494323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE SCHRADER

Provider Business Mailing Address
First Line	:	1623 SAINT PAUL ST
Second Line	:	UNIT 404
City	:	DENVER
State	:	CO
Zip	:	80206-1665
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1623 SAINT PAUL ST
Second Line	:	UNIT 404
City	:	DENVER
State	:	CO
Zip	:	80206-1665
Country	:	US
Telephone Number	:	720-939-1921
Fax Number	:

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

Provider Enumeration Date	:	03/05/2014
Last Update Date	:	03/05/2014

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Directions to “ JASMINE SCHRADER ” Practice Location

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