Basic Information
| Provider Information | |||||||||
| NPI: | 1720753122 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHANER | ||||||||
| FirstName: | HALEY | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 PINNACLE DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | PAPILLION | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680466228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025057989 | ||||||||
| FaxNumber: | 4029328863 | ||||||||
| Practice Location | |||||||||
| Address1: | 13616 CALIFORNIA ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681545336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024960404 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2021 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 2559 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.