Provider Demographics
NPI:1033317722
Name:SCHROER, KYLENE MARIE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KYLENE
Middle Name:MARIE
Last Name:SCHROER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 N KANSAS AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4438
Mailing Address - Country:US
Mailing Address - Phone:402-461-5265
Mailing Address - Fax:402-461-5270
Practice Address - Street 1:715 N KANSAS AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4438
Practice Address - Country:US
Practice Address - Phone:402-461-5265
Practice Address - Fax:402-461-5270
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110853363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE254815OtherMIDLANDS CHOICE
NE10025076100OtherMEDICAID FQHC
NE10025079900Medicaid
NE39166OtherBCBS
NE10024980200Medicaid
NE10025076100OtherMEDICAID FQHC