Healthcare Provider Details

I. General information

NPI: 1992190235
Provider Name (Legal Business Name): SAMANTHA LYNN SCHNEIDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2015
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 VISTA LN STE 120
CARSON CITY NV
89703-4633
US

IV. Provider business mailing address

1525 VISTA LN STE 120
CARSON CITY NV
89703-4633
US

V. Phone/Fax

Practice location:
  • Phone: 775-451-3376
  • Fax: 775-490-0186
Mailing address:
  • Phone: 775-451-3376
  • Fax: 775-490-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number19793
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number19793
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: