Healthcare Provider Details

I. General information

NPI: 1013075464
Provider Name (Legal Business Name): KRISHNA L SCHMIDT PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CARONDELET DR SUITE 125
KANSAS CITY MO
64114-4859
US

IV. Provider business mailing address

1010 CARONDELET DR SUITE 125
KANSAS CITY MO
64114-4859
US

V. Phone/Fax

Practice location:
  • Phone: 816-942-1150
  • Fax: 816-942-0322
Mailing address:
  • Phone: 816-942-1150
  • Fax: 816-942-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2015044614
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: