Provider Demographics
NPI:1730646050
Name:SCHMIDT, BECKI RENAE
Entity type:Individual
Prefix:MRS
First Name:BECKI
Middle Name:RENAE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 D ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBURY
Mailing Address - State:NE
Mailing Address - Zip Code:68352-1917
Mailing Address - Country:US
Mailing Address - Phone:402-520-2083
Mailing Address - Fax:
Practice Address - Street 1:703 K ST
Practice Address - Street 2:
Practice Address - City:FAIRBURY
Practice Address - State:NE
Practice Address - Zip Code:68352-2199
Practice Address - Country:US
Practice Address - Phone:402-729-6104
Practice Address - Fax:402-729-6392
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19402164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse