Provider Demographics
NPI:1053079384
Name:SCHROEDER, RENAE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RENAE
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 PROFESSIONAL PL STE 207
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-8106
Mailing Address - Country:US
Mailing Address - Phone:719-900-1788
Mailing Address - Fax:
Practice Address - Street 1:5445 MARK DABLING BLVD STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3850
Practice Address - Country:US
Practice Address - Phone:719-678-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997175-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health