Provider Demographics
NPI:1639710700
Name:SCHRADER, KYMBERLEY ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:KYMBERLEY
Middle Name:ANNE
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KYMBERLEY
Other - Middle Name:ANNE
Other - Last Name:SCHRADER-XENIDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:4755 OGLETOWN STANTON RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-623-4370
Mailing Address - Fax:302-623-4375
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:302-623-4370
Practice Address - Fax:302-623-4375
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0024920163W00000X
DELI-0024920163WH0200X
DELG-0001354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health