Healthcare Provider Details

I. General information

NPI: 1306455506
Provider Name (Legal Business Name): MARIAH C. SCHAAF ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAH C. SELBY

II. Dates (important events)

Enumeration Date: 07/24/2020
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 E PIERCE ST
COUNCIL BLUFFS IA
51503-4626
US

IV. Provider business mailing address

PO BOX 3755
OMAHA NE
68103-0755
US

V. Phone/Fax

Practice location:
  • Phone: 712-396-4360
  • Fax: 712-396-7069
Mailing address:
  • Phone: 402-354-4230
  • Fax: 402-354-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberH159699
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: