Healthcare Provider Details

I. General information

NPI: 1356966618
Provider Name (Legal Business Name): LAURA SCHLIESSER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19751 SW 58TH ST
HALLAM NE
68368-2055
US

IV. Provider business mailing address

19751 SW 58TH ST
HALLAM NE
68368-2055
US

V. Phone/Fax

Practice location:
  • Phone: 402-499-4553
  • Fax:
Mailing address:
  • Phone: 402-499-4553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number115427
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number72505
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: