Provider Demographics
NPI:1992887129
Name:SCHNACKER, AMY L (OTRL)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:SCHNACKER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:NE
Mailing Address - Zip Code:68937-5224
Mailing Address - Country:US
Mailing Address - Phone:308-440-5357
Mailing Address - Fax:
Practice Address - Street 1:407 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:NE
Practice Address - Zip Code:68937-5224
Practice Address - Country:US
Practice Address - Phone:308-440-5357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE880225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025364800Medicaid