Provider Demographics
NPI:1023686482
Name:SCHROEDER, ASHLEY HENNINGSA (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:HENNINGSA
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:HENNINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:185 WADSWORTH RD STE J
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9585
Mailing Address - Country:US
Mailing Address - Phone:330-334-7800
Mailing Address - Fax:
Practice Address - Street 1:185 WADSWORTH RD STE J
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9585
Practice Address - Country:US
Practice Address - Phone:330-334-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1177154208600000X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No208600000XAllopathic & Osteopathic PhysiciansSurgery