Provider Demographics
NPI:1851941686
Name:SCHROEDER, GLORIA EVELAN
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:EVELAN
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55921
Mailing Address - Country:US
Mailing Address - Phone:507-725-2826
Mailing Address - Fax:
Practice Address - Street 1:117 N 1ST STREET
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MN
Practice Address - Zip Code:55921
Practice Address - Country:US
Practice Address - Phone:507-725-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider