Healthcare Provider Details

I. General information

NPI: 1497257612
Provider Name (Legal Business Name): KERRY ANN SCHMIDT M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRY ANN HILL M.S. CCC-SLP

II. Dates (important events)

Enumeration Date: 03/03/2018
Last Update Date: 03/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 FRANCE AVE S STE 305
EDINA MN
55435-4313
US

IV. Provider business mailing address

7250 FRANCE AVE S
EDINA MN
55435-4305
US

V. Phone/Fax

Practice location:
  • Phone: 952-285-2840
  • Fax:
Mailing address:
  • Phone: 952-285-2840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number190106
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10033
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: