Healthcare Provider Details

I. General information

NPI: 1346544715
Provider Name (Legal Business Name): HEIDI ANN SCHMIDT R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 FEEDLOT RD
ELLIS KS
67637-9306
US

IV. Provider business mailing address

375 FEEDLOT RD
ELLIS KS
67637-9306
US

V. Phone/Fax

Practice location:
  • Phone: 785-726-1133
  • Fax:
Mailing address:
  • Phone: 785-726-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number13102709091
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: