Provider Demographics
NPI:1316378557
Name:SCHNEIDER, BRANDI (OTR)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6205 W LOCKARD RD
Mailing Address - Street 2:
Mailing Address - City:CULVER
Mailing Address - State:KS
Mailing Address - Zip Code:67484-9316
Mailing Address - Country:US
Mailing Address - Phone:785-493-5828
Mailing Address - Fax:
Practice Address - Street 1:123 INDIANA AVE STE C
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3213
Practice Address - Country:US
Practice Address - Phone:785-825-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01426172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker