Provider Demographics
NPI:1396463626
Name:SCHNEIDER, SANDRA
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:SCHNEIDER
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 1:620 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DAZEY
Mailing Address - State:ND
Mailing Address - Zip Code:58429-4009
Mailing Address - Country:US
Mailing Address - Phone:701-733-2275
Mailing Address - Fax:
Practice Address - Street 1:620 4TH ST
Practice Address - Street 2:
Practice Address - City:DAZEY
Practice Address - State:ND
Practice Address - Zip Code:58429-4009
Practice Address - Country:US
Practice Address - Phone:701-733-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant