Provider Demographics
NPI:1730433004
Name:SCHNELL, ANDREA JC (LMT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JC
Last Name:SCHNELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 27TH ST APT A38
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2279
Mailing Address - Country:US
Mailing Address - Phone:402-515-9454
Mailing Address - Fax:
Practice Address - Street 1:3763 39TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4544
Practice Address - Country:US
Practice Address - Phone:402-606-4492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2745225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist