Healthcare Provider Details

I. General information

NPI: 1881427268
Provider Name (Legal Business Name): SHAWNA BROOKE SNIDER-ALEXANDER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAWNA BROOKE SNIDER

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 HIGHWAY 30 E
KEARNEY NE
68847-9797
US

IV. Provider business mailing address

915 W 78TH ST
KEARNEY NE
68845-8409
US

V. Phone/Fax

Practice location:
  • Phone: 308-237-8777
  • Fax:
Mailing address:
  • Phone: 308-627-4116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number115826
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number88811
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: