Provider Demographics
NPI:1073269072
Name:SCHLICKBERND, STEPHEN E (APRN)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:E
Last Name:SCHLICKBERND
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4303
Mailing Address - Country:US
Mailing Address - Phone:308-630-0800
Mailing Address - Fax:308-630-0842
Practice Address - Street 1:3210 AVENUE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4303
Practice Address - Country:US
Practice Address - Phone:308-630-0800
Practice Address - Fax:308-630-0842
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114037363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner