Provider Demographics
NPI:1750023792
Name:SCHROEDER, AMBER IVY (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:IVY
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 10TH ST
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-3531
Mailing Address - Country:US
Mailing Address - Phone:307-587-4255
Mailing Address - Fax:
Practice Address - Street 1:1225 10TH ST
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-3531
Practice Address - Country:US
Practice Address - Phone:307-587-4255
Practice Address - Fax:307-587-9369
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY27405163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse