Basic Information
| Provider Information | |||||||||
| NPI: | 1235519760 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SCHRODER | ||||||||
| FirstName: | LORI | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10238 E HAMPTON AVE | ||||||||
| Address2: | STE 508 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852093321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808347546 | ||||||||
| FaxNumber: | 4808338313 | ||||||||
| Practice Location | |||||||||
| Address1: | 9250 N 3RD ST | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850202437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026333848 | ||||||||
| FaxNumber: | 6026333841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2015 | ||||||||
| LastUpdateDate: | 02/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP7851 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.