Healthcare Provider Details

I. General information

NPI: 1508466756
Provider Name (Legal Business Name): AMBER LYNN SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 STADLER ST
TURTLE LAKE ND
58575-4314
US

IV. Provider business mailing address

905 MARION DR
UNDERWOOD ND
58576-4213
US

V. Phone/Fax

Practice location:
  • Phone: 701-448-2289
  • Fax:
Mailing address:
  • Phone: 701-400-7142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: