Healthcare Provider Details

I. General information

NPI: 1992855993
Provider Name (Legal Business Name): JODENE SCHMIDT P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N 96TH ST STE 200
OMAHA NE
68114-2499
US

IV. Provider business mailing address

1721 COLFAX ST
SCHUYLER NE
68661-1400
US

V. Phone/Fax

Practice location:
  • Phone: 402-343-4328
  • Fax:
Mailing address:
  • Phone: 402-352-3745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number903
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: