Provider Demographics
NPI:1265103360
Name:SCHROEDER, KEREN MICHELE (NBC-HWC)
Entity type:Individual
Prefix:
First Name:KEREN
Middle Name:MICHELE
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 E RIMRUNNER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1324
Mailing Address - Country:US
Mailing Address - Phone:720-851-4231
Mailing Address - Fax:
Practice Address - Street 1:3419 E RIMRUNNER DR
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1324
Practice Address - Country:US
Practice Address - Phone:720-851-4231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date: