Provider Demographics
NPI:1801324777
Name:SCHRADER, AUTUMN RENE' (RN)
Entity type:Individual
Prefix:MRS
First Name:AUTUMN
Middle Name:RENE'
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2523
Mailing Address - Country:US
Mailing Address - Phone:740-772-6191
Mailing Address - Fax:740-772-6188
Practice Address - Street 1:18 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2523
Practice Address - Country:US
Practice Address - Phone:740-772-6191
Practice Address - Fax:740-772-6188
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH391164163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse