Provider Demographics
NPI:1386922789
Name:SCHNITZLER, TINA LYNN
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:LYNN
Last Name:SCHNITZLER
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 1:2510 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68826-2123
Mailing Address - Country:US
Mailing Address - Phone:308-946-3845
Mailing Address - Fax:308-946-2145
Practice Address - Street 1:2510 18TH AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-2123
Practice Address - Country:US
Practice Address - Phone:308-946-3845
Practice Address - Fax:308-946-2145
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11183164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse