Healthcare Provider Details

I. General information

NPI: 1245044908
Provider Name (Legal Business Name): ANDREA SCHMITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 S HALL ST
VALENTINE NE
69201-2156
US

IV. Provider business mailing address

30019 S SCALP RD
FAIRFAX SD
57335-5322
US

V. Phone/Fax

Practice location:
  • Phone: 402-376-2900
  • Fax:
Mailing address:
  • Phone: 605-830-2432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberR054382
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: