Provider Demographics
NPI:1659338127
Name:SCHROEDER-BRUCE, KATHRYN (RN MS)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:SCHROEDER-BRUCE
Suffix:
Gender:F
Credentials:RN MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 ALEXANDER ST
Mailing Address - Street 2:STE 304
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1941
Mailing Address - Country:US
Mailing Address - Phone:585-262-4800
Mailing Address - Fax:585-262-4807
Practice Address - Street 1:253 ALEXANDER STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2520
Practice Address - Country:US
Practice Address - Phone:585-262-4800
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400109363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
106055FCOtherPRETCARE
R8554OtherBCBS