Provider Demographics
NPI:1780121491
Name:SCHRADER, KRISTINA MICHELLE (RRT, RCP)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:MICHELLE
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:RRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 BIRDIE CT
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9777
Mailing Address - Country:US
Mailing Address - Phone:910-401-7482
Mailing Address - Fax:
Practice Address - Street 1:5501 BIRDIE CT
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-9777
Practice Address - Country:US
Practice Address - Phone:910-401-7482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-3124227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered