Healthcare Provider Details

I. General information

NPI: 1184042632
Provider Name (Legal Business Name): MS. ASHLEY MARIE SCHMITT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ASHLEY MARIE HASELEU

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N JACKSON AVE
SPRINGFIELD MN
56087-1714
US

IV. Provider business mailing address

625 N JACKSON AVE
SPRINGFIELD MN
56087-1714
US

V. Phone/Fax

Practice location:
  • Phone: 507-723-6201
  • Fax: 507-723-6447
Mailing address:
  • Phone: 507-723-6201
  • Fax: 507-723-6447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR184440-1
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1270
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1270
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: