Provider Demographics
NPI:1376112664
Name:SCHROEDER, MORGAN KATHERINE (PA)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:KATHERINE
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SHANE DR
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-4102
Mailing Address - Country:US
Mailing Address - Phone:270-651-4772
Mailing Address - Fax:
Practice Address - Street 1:210 SHANE DR
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-4102
Practice Address - Country:US
Practice Address - Phone:270-651-4772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2784363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant