Healthcare Provider Details

I. General information

NPI: 1467155911
Provider Name (Legal Business Name): JESSICA ELIZABETH SCHMIDT MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N EAST AVE # 5T
JACKSON MI
49201-1753
US

IV. Provider business mailing address

205 N EAST AVE # 4T5T
JACKSON MI
49201-1753
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-0556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number4704315028
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: