Provider Demographics
NPI:1093486615
Name:SCHLEDER, KELLI LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:LYNN
Last Name:SCHLEDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:12750 ST FRANCIS DR STE 320
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-0264
Practice Address - Country:US
Practice Address - Phone:219-662-0077
Practice Address - Fax:219-662-9496
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209023205363L00000X
IN71011600A363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner