Basic Information
Provider Information
NPI: 1962424523
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHUE
FirstName: RICHARD
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2400 32ND AVE S
Address2:  
City: FARGO
State: ND
PostalCode: 581035800
CountryCode: US
TelephoneNumber: 7012348860
FaxNumber: 7012348803
Practice Location
Address1: 2400 32ND AVE S
Address2:  
City: FARGO
State: ND
PostalCode: 581035800
CountryCode: US
TelephoneNumber: 7012348860
FaxNumber: 7012348803
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 09/10/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XR18295NDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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