Provider Demographics
NPI:1558854950
Name:SCHOOLER-NUSS, LISA RENE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RENE
Last Name:SCHOOLER-NUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 109
Mailing Address - Street 2:
Mailing Address - City:WILLOW
Mailing Address - State:AK
Mailing Address - Zip Code:99688-0109
Mailing Address - Country:US
Mailing Address - Phone:907-444-1921
Mailing Address - Fax:
Practice Address - Street 1:26526 W. BERYOZOVA DR.
Practice Address - Street 2:
Practice Address - City:WILLOW
Practice Address - State:AK
Practice Address - Zip Code:99688-0109
Practice Address - Country:US
Practice Address - Phone:907-444-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist