Healthcare Provider Details

I. General information

NPI: 1407140932
Provider Name (Legal Business Name): JAMIE L. SCHNEIDER A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 MARC WAGNER DR
VICTORIA KS
67671-9589
US

IV. Provider business mailing address

208 MARC WAGNER DR
VICTORIA KS
67671-9589
US

V. Phone/Fax

Practice location:
  • Phone: 785-735-2210
  • Fax: 785-735-2229
Mailing address:
  • Phone: 785-735-2210
  • Fax: 785-735-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-75387-022
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5375387022
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: