Provider Demographics
NPI:1407140932
Name:SCHNEIDER, JAMIE L (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:L
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MARC WAGNER DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:KS
Mailing Address - Zip Code:67671-9589
Mailing Address - Country:US
Mailing Address - Phone:785-735-2210
Mailing Address - Fax:785-735-2229
Practice Address - Street 1:208 MARC WAGNER DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:KS
Practice Address - Zip Code:67671-9589
Practice Address - Country:US
Practice Address - Phone:785-735-2210
Practice Address - Fax:785-735-2229
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5375387022207Q00000X
KS53-75387-022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS20033390AMedicaid