Provider Demographics
NPI:1033213574
Name:SCHROEDER, TAMMY M (APRN)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:M
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:M
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-0220
Mailing Address - Country:US
Mailing Address - Phone:402-826-2102
Mailing Address - Fax:402-826-7950
Practice Address - Street 1:2910 BETTEN DR
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-3084
Practice Address - Country:US
Practice Address - Phone:402-826-2102
Practice Address - Fax:402-826-7950
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110522363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100249883 00Medicaid
NE37950OtherBCBS
278862Medicare ID - Type Unspecified
NE100249883 00Medicaid
P00240531Medicare ID - Type UnspecifiedRRM
NE275805Medicare PIN