Healthcare Provider Details

I. General information

NPI: 1710602081
Provider Name (Legal Business Name): FRANCES CHARLES SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/10/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 MARION AVE
MCCOMB MS
39648-3620
US

IV. Provider business mailing address

2082 HIGHWAY 570 W
SUMMIT MS
39666-7117
US

V. Phone/Fax

Practice location:
  • Phone: 601-684-3210
  • Fax:
Mailing address:
  • Phone: 601-551-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number905620
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: