Provider Demographics
NPI:1669108882
Name:SCHWEDER, KATLYN MICHELLE (CNP)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:MICHELLE
Last Name:SCHWEDER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KATLYN
Other - Middle Name:MICHELLE
Other - Last Name:MELLIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1901 OLD MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082-1763
Mailing Address - Country:US
Mailing Address - Phone:507-934-2325
Mailing Address - Fax:
Practice Address - Street 1:1901 OLD MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT PETER
Practice Address - State:MN
Practice Address - Zip Code:56082-1763
Practice Address - Country:US
Practice Address - Phone:507-934-2325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9726363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily