Provider Demographics
NPI:1104197805
Name:SCHRINER, KENNETH DONALD (RN)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:DONALD
Last Name:SCHRINER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1021
Mailing Address - Country:US
Mailing Address - Phone:330-718-3754
Mailing Address - Fax:
Practice Address - Street 1:1917 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-1021
Practice Address - Country:US
Practice Address - Phone:330-718-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN280218163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2118952Medicaid