Provider Demographics
NPI:1588448989
Name:SCHROEDER, ANA STEPHANY (NP-BC)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:STEPHANY
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:STEPHANY
Other - Middle Name:
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-BC
Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11104 PARKVIEW CIRCLE DR STE 310
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1733
Practice Address - Country:US
Practice Address - Phone:260-266-5230
Practice Address - Fax:260-266-5238
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28232345A163W00000X
IN71014582A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse