1639185861 NPI number — MS. LYNN M SCHROEDER LLP

Table of content: MS. LYNN M SCHROEDER LLP (NPI 1639185861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639185861 NPI number — MS. LYNN M SCHROEDER LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHROEDER
Provider First Name:
LYNN
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PICKARD
Provider Other First Name:
LYNN
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639185861
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 KRAFFT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT GRATIOT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48059-3565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-985-5125
Provider Business Mailing Address Fax Number:
810-985-5127

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 KRAFFT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT GRATIOT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48059-3565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-985-5125
Provider Business Practice Location Address Fax Number:
810-985-5127
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X , with the licence number:  6301010996 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 139863PY . This is a "CARE CHOICES HMO" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: LS010996 . This is a "BLUE CROSS BLUE SHIELD MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com