Provider Demographics
NPI:1629354634
Name:SCHROEDER, PATRICIA G (NP-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:G
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:G
Other - Last Name:TARRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5794
Mailing Address - Country:US
Mailing Address - Phone:920-996-3264
Mailing Address - Fax:920-830-5970
Practice Address - Street 1:1818 N MEADE ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-3454
Practice Address - Country:US
Practice Address - Phone:920-731-8900
Practice Address - Fax:920-225-1414
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000978363L00000X
TX751526363LF0000X
WI9102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner