MEDICARE: JORDAN SCHMIDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	557386	KS

General Provider Information

NPI Number	:	1477926418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN SCHMIDT

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8048
Country	:	US
Telephone Number	:	913-588-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2015
Last Update Date	:	06/23/2020

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Directions to “ JORDAN SCHMIDT ” Practice Location

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