Basic Information
Provider Information
NPI: 1407287758
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHUELKE
FirstName: STEPHANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 575 S 70TH ST
Address2: SUITE 300
City: LINCOLN
State: NE
PostalCode: 685102471
CountryCode: US
TelephoneNumber: 4022197498
FaxNumber: 4022197327
Practice Location
Address1: 575 S 70TH ST
Address2: SUITE 300
City: LINCOLN
State: NE
PostalCode: 685102471
CountryCode: US
TelephoneNumber: 4022197498
FaxNumber: 4022197327
Other Information
ProviderEnumerationDate: 12/11/2013
LastUpdateDate: 12/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X3296NEY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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