Provider Demographics
NPI:1467261859
Name:ZNAMENACEK, ANDREW SCOTT
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:SCOTT
Last Name:ZNAMENACEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E ASHTON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-7821
Mailing Address - Country:US
Mailing Address - Phone:308-390-2535
Mailing Address - Fax:
Practice Address - Street 1:2922 W 5TH ST APT 3
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4162
Practice Address - Country:US
Practice Address - Phone:308-390-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion