Healthcare Provider Details

I. General information

NPI: 1407472244
Provider Name (Legal Business Name): CHANDA SCHROYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1100 W 14TH ST
HASTINGS NE
68901-3064
US

IV. Provider business mailing address

1924 W A ST
HASTINGS NE
68901-5650
US

V. Phone/Fax

Practice location:
  • Phone: 402-461-7550
  • Fax:
Mailing address:
  • Phone: 402-461-7578
  • Fax: 402-461-7509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number87048
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: