Provider Demographics
NPI:1265132005
Name:SCHAEDLER, KRISTEY
Entity type:Individual
Prefix:
First Name:KRISTEY
Middle Name:
Last Name:SCHAEDLER
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 1:706 13TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-2318
Mailing Address - Country:US
Mailing Address - Phone:701-214-0045
Mailing Address - Fax:
Practice Address - Street 1:706 13TH AVE NW
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-2318
Practice Address - Country:US
Practice Address - Phone:701-214-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant