Provider Demographics
NPI:1326925454
Name:SCHROEDEL, PARKER
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:
Last Name:SCHROEDEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 CHESTNUT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:FORT WAINWRIGHT
Mailing Address - State:AK
Mailing Address - Zip Code:99703-1394
Mailing Address - Country:US
Mailing Address - Phone:404-838-8894
Mailing Address - Fax:
Practice Address - Street 1:19 COLLEGE RD STE D
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-1749
Practice Address - Country:US
Practice Address - Phone:907-458-5670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA04410225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant