Provider Demographics
NPI:1194894121
Name:SCHILZ, SUREE MICHELLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SUREE
Middle Name:MICHELLE
Last Name:SCHILZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:FRIEND
Mailing Address - State:NE
Mailing Address - Zip Code:68359-1116
Mailing Address - Country:US
Mailing Address - Phone:402-947-2021
Mailing Address - Fax:402-947-2127
Practice Address - Street 1:1210 2ND ST
Practice Address - Street 2:
Practice Address - City:FRIEND
Practice Address - State:NE
Practice Address - Zip Code:68359-1116
Practice Address - Country:US
Practice Address - Phone:402-947-2021
Practice Address - Fax:402-947-2127
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1110363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP96595Medicare UPIN