Provider Demographics
NPI:1205437555
Name:SCHROEDER, CHRISTOPHER JOHN
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-9183
Mailing Address - Country:US
Mailing Address - Phone:620-899-0875
Mailing Address - Fax:
Practice Address - Street 1:200 S 5TH ST STE A
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3906
Practice Address - Country:US
Practice Address - Phone:785-827-2238
Practice Address - Fax:785-827-1684
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS557834367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSSTUDENTMedicaid