Provider Demographics
NPI:1831287770
Name:SCHUMACHER, DIANE GAIL (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:GAIL
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:GAIL
Other - Last Name:EGGERLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1700 N VICTORY RD
Mailing Address - Street 2:BOX 1209
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-6859
Mailing Address - Country:US
Mailing Address - Phone:402-370-3400
Mailing Address - Fax:
Practice Address - Street 1:1700 N VICTORY RD
Practice Address - Street 2:BOX 1209
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-6859
Practice Address - Country:US
Practice Address - Phone:402-370-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE387363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE269122Medicare ID - Type Unspecified