Healthcare Provider Details

I. General information

NPI: 1073594149
Provider Name (Legal Business Name): THERESA ELAINE SCHMITZ A.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3211 PROVIDENCE DR
ANCHORAGE AK
99508-4614
US

IV. Provider business mailing address

4761 MARS DR
ANCHORAGE AK
99507-3724
US

V. Phone/Fax

Practice location:
  • Phone: 907-786-4040
  • Fax: 907-786-4049
Mailing address:
  • Phone: 907-346-1492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number12613
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number491
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: