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NPI Code Detail

MEDICARE: SHELLY M SCHUTTE P-AC

MEDICARE: SHELLY M SCHUTTE P-AC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant878NE
2363A00000XPhysician Assistant075825IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
137753OTHERNEBCBSNE

General Provider Information

NPI Number : 1588696413
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLY M SCHUTTE P-AC
Provider Business Mailing Address
First Line : PO BOX 3755
Second Line :
City : OMAHA
State : NE
Zip : 68103-0755
Country : US
Telephone Number : 402-354-2100
Fax Number : 402-354-2155
Provider Business Practice Location Address
First Line : 7831 CHICAGO CT
Second Line :
City : OMAHA
State : NE
Zip : 68114-3654
Country : US
Telephone Number : 402-354-1230
Fax Number : 402-354-1235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 01/08/2025

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Directions to “ SHELLY M SCHUTTE P-AC” Practice Location

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