Provider Demographics
NPI:1265920177
Name:SCHROER, CASSANDRA LYNNE (NP)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:LYNNE
Last Name:SCHROER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3397 N CAMELLIA
Mailing Address - Street 2:
Mailing Address - City:LOCKESBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71846-9608
Mailing Address - Country:US
Mailing Address - Phone:870-289-5190
Mailing Address - Fax:
Practice Address - Street 1:3397 N CAMELLIA
Practice Address - Street 2:
Practice Address - City:LOCKESBURG
Practice Address - State:AR
Practice Address - Zip Code:71846-9608
Practice Address - Country:US
Practice Address - Phone:870-289-5190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200801320AMedicaid