Provider Demographics
NPI:1508278730
Name:SCHODROSKI, SECIL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SECIL
Middle Name:
Last Name:SCHODROSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9717 LANDMARK PARKWAY DR STE 115
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1662
Mailing Address - Country:US
Mailing Address - Phone:636-795-9536
Mailing Address - Fax:314-722-6551
Practice Address - Street 1:9717 LANDMARK PARKWAY DR STE 115
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1662
Practice Address - Country:US
Practice Address - Phone:314-722-6555
Practice Address - Fax:314-722-6551
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014014296363LP2300X, 363LF0000X
MO2006032413163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical