Healthcare Provider Details

I. General information

NPI: 1528779717
Provider Name (Legal Business Name): SUSAN SCHMIETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUSAN SCHMEITT

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 02/02/2024
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S CHESTNUT
NORTH PLATTE NE
69101-1209
US

IV. Provider business mailing address

P.O. BOX 1209
NORTH PLATTE NE
69103-1209
US

V. Phone/Fax

Practice location:
  • Phone: 308-532-4860
  • Fax: 308-532-4737
Mailing address:
  • Phone: 308-534-0440
  • Fax: 308-534-8775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCPSS-184
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: