Basic Information
| Provider Information | |||||||||
| NPI: | 1528658168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHOOLER | ||||||||
| FirstName: | TARA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RD LD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CROTTS | ||||||||
| OtherFirstName: | TARA | ||||||||
| OtherMiddleName: | ELIZABETH | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11424 NW 25TH ST | ||||||||
| Address2: | |||||||||
| City: | SILVER LAKE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 665399405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7859694736 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 634 SW MULVANE ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852722240 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2021 | ||||||||
| LastUpdateDate: | 01/18/2021 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 2238 | KS | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.