Provider Demographics
NPI:1215742184
Name:SCHUTTE, WANDA GAE
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:GAE
Last Name:SCHUTTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 W OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-6208
Mailing Address - Country:US
Mailing Address - Phone:308-380-2914
Mailing Address - Fax:
Practice Address - Street 1:2407 W OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-6208
Practice Address - Country:US
Practice Address - Phone:308-380-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant