Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 00000 | NE |
NPI | 1033594817 |
---|---|
Provider Name | Scott Schroeder |
First Address | Lincoln, NE 68502-3704 |
Second Address | Lincoln, NE 68502-3704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2015 |
Last Update Date | 22/07/2015 |