Provider Demographics
NPI:1841949245
Name:MENDEZ, AMY SUE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:SUE
Last Name:MENDEZ
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 1:418 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SCHUYLER
Mailing Address - State:NE
Mailing Address - Zip Code:68661-1705
Mailing Address - Country:US
Mailing Address - Phone:402-615-2778
Mailing Address - Fax:
Practice Address - Street 1:401 ADAM ST
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NE
Practice Address - Zip Code:68661-2468
Practice Address - Country:US
Practice Address - Phone:402-352-3527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant