Provider Demographics
NPI:1568809549
Name:VONDERSCHMIDT, CORLAN J (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CORLAN
Middle Name:J
Last Name:VONDERSCHMIDT
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:2222 S 16TH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3796
Mailing Address - Country:US
Mailing Address - Phone:402-488-3002
Mailing Address - Fax:402-483-8787
Practice Address - Street 1:2222 S 16TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3796
Practice Address - Country:US
Practice Address - Phone:402-488-3002
Practice Address - Fax:402-483-8787
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2023-08-30
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical