Provider Demographics
NPI:1477892727
Name:SCHIEDEL, KRISTEN MARIE (RN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIE
Last Name:SCHIEDEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:MARIE
Other - Last Name:GEPPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:21 MEADOWLARK DR.
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450
Mailing Address - Country:US
Mailing Address - Phone:585-760-4267
Mailing Address - Fax:
Practice Address - Street 1:80 W CHURCH ST
Practice Address - Street 2:UPPER
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-2140
Practice Address - Country:US
Practice Address - Phone:585-760-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY505374-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics