Healthcare Provider Details

I. General information

NPI: 1093175606
Provider Name (Legal Business Name): ANN M SCHUCHARDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN M BREWER

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2668 S 191ST CIR
OMAHA NE
68130-2924
US

IV. Provider business mailing address

2668 S 191ST CIR
OMAHA NE
68130-2924
US

V. Phone/Fax

Practice location:
  • Phone: 402-982-0050
  • Fax: 855-290-5531
Mailing address:
  • Phone: 402-689-1201
  • Fax: 855-290-5531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number56322
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: