Healthcare Provider Details

I. General information

NPI: 1841587193
Provider Name (Legal Business Name): KARA DIANNE WILKIE SCHMID RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 SMITH AVE N SUITE 404
SAINT PAUL MN
55102-2387
US

IV. Provider business mailing address

347 SMITH AVE N SUITE 404
SAINT PAUL MN
55102-2387
US

V. Phone/Fax

Practice location:
  • Phone: 651-220-6624
  • Fax: 651-220-6064
Mailing address:
  • Phone: 651-220-6624
  • Fax: 651-220-6064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR1441985
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: