Healthcare Provider Details

I. General information

NPI: 1568449338
Provider Name (Legal Business Name): CHRISTOPHER EHREN SCHMIDT APRN-BC ENP CEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PRUDENTIAL DR
JACKSONVILLE FL
32207-8202
US

IV. Provider business mailing address

24 MARSHVIEW DR
ST AUGUSTINE FL
32080-5873
US

V. Phone/Fax

Practice location:
  • Phone: 616-560-3087
  • Fax:
Mailing address:
  • Phone: 386-871-9770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2221352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: