Provider Demographics
NPI:1518327758
Name:SCHROEDER, LINNEA R (PAC)
Entity Type:Individual
Prefix:
First Name:LINNEA
Middle Name:R
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80807-1523
Mailing Address - Country:US
Mailing Address - Phone:719-207-0186
Mailing Address - Fax:719-346-9485
Practice Address - Street 1:182 16TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-1649
Practice Address - Country:US
Practice Address - Phone:719-346-9481
Practice Address - Fax:719-346-9485
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4547363A00000X
ORPA209096363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant