Healthcare Provider Details

I. General information

NPI: 1558440040
Provider Name (Legal Business Name): LORI SCHMIDT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 4TH ST N
FARGO ND
58102-4820
US

IV. Provider business mailing address

PO BOX 2625
FARGO ND
58108-2625
US

V. Phone/Fax

Practice location:
  • Phone: 701-239-7111
  • Fax:
Mailing address:
  • Phone: 701-239-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR0922599
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR24246
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR24246
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: