Provider Demographics
NPI:1952531055
Name:DOERNEMANN, SANDRA LEE (APRN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:DOERNEMANN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LEE
Other - Last Name:SCHNOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1721 COLFAX ST
Mailing Address - Street 2:
Mailing Address - City:SCHUYLER
Mailing Address - State:NE
Mailing Address - Zip Code:68661-1400
Mailing Address - Country:US
Mailing Address - Phone:402-352-3745
Mailing Address - Fax:402-352-8750
Practice Address - Street 1:1721 COLFAX ST
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NE
Practice Address - Zip Code:68661-1400
Practice Address - Country:US
Practice Address - Phone:402-352-3745
Practice Address - Fax:402-352-8750
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111055363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE111055OtherSTATE LICENSE