Healthcare Provider Details

I. General information

NPI: 1104015833
Provider Name (Legal Business Name): DARA DAWN SCHUSTER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 7TH ST
AURORA NE
68818-1141
US

IV. Provider business mailing address

401 W 10 RD
PHILLIPS NE
68865-2103
US

V. Phone/Fax

Practice location:
  • Phone: 402-694-3171
  • Fax:
Mailing address:
  • Phone: 402-886-4636
  • Fax: 402-886-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number357000
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: