MEDICARE: AMANDA C. SCHMIDGALL CRNA

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	209009612	IL
2	367500000X	Certified Registered Nurse Anesthetist	APN.0992149	CO

General Provider Information

NPI Number	:	1518222660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA C. SCHMIDGALL CRNA

Provider Business Mailing Address
First Line	:	PO BOX 176221
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80217-6221
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 APACHE WAY
Second Line	:
City	:	GROVELAND
State	:	IL
Zip	:	61535-9404
Country	:	US
Telephone Number	:	312-399-2612
Fax Number	:

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

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	08/25/2025

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