Provider Demographics
NPI:1992497457
Name:SCHROEDER, JENNIFER L (CNA/QSP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:CNA/QSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10209 30TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329-9431
Mailing Address - Country:US
Mailing Address - Phone:701-480-9924
Mailing Address - Fax:
Practice Address - Street 1:10209 30TH AVE NE
Practice Address - Street 2:
Practice Address - City:DUNSEITH
Practice Address - State:ND
Practice Address - Zip Code:58329-9431
Practice Address - Country:US
Practice Address - Phone:701-480-9924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND41659376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide