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General NPI Number Information
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NPI Number | 1558854950
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Entity Type | Individual
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Provider Name | LISA RENE SCHOOLER-NUSS
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 26526 W. BERYOZOVA DR.
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City | WILLOW
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State | AK
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Zip | 99688-0109
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Country | US
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Telephone | 907-444-1921
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 109
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City | WILLOW
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State | AK
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Zip | 99688-0109
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Country | US
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Telephone | 907-444-1921
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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