Healthcare Provider Details

I. General information

NPI: 1013214964
Provider Name (Legal Business Name): DENISE SNODGRASS SAHELE A.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2011
Last Update Date: 02/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 SOUTH ST # 17TH
LINCOLN NE
68502-2743
US

IV. Provider business mailing address

2201 SOUTH ST # L7TH
LINCOLN NE
68502-2743
US

V. Phone/Fax

Practice location:
  • Phone: 402-441-7940
  • Fax: 402-441-8625
Mailing address:
  • Phone: 402-441-7940
  • Fax: 402-441-8625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: