Provider Demographics
NPI:1962020248
Name:PRESTIGE TOTAL HEALTH OF NEBRASKA, LLC
Entity type:Organization
Organization Name:PRESTIGE TOTAL HEALTH OF NEBRASKA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO/APRN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, AGACNP-BC
Authorized Official - Phone:407-656-6562
Mailing Address - Street 1:912 BUTTER OAKS CT
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2014
Mailing Address - Country:US
Mailing Address - Phone:919-744-1592
Mailing Address - Fax:
Practice Address - Street 1:912 BUTTER OAKS CT
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2014
Practice Address - Country:US
Practice Address - Phone:338-656-6562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty