Healthcare Provider Details

I. General information

NPI: 1598446742
Provider Name (Legal Business Name): TRACEY LYNN SCHMIDT MSN, AGNP-C, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 10TH ST
NIAGARA FALLS NY
14301-1813
US

IV. Provider business mailing address

3385 WARNER DR
GRAND ISLAND NY
14072-1041
US

V. Phone/Fax

Practice location:
  • Phone: 716-278-4000
  • Fax:
Mailing address:
  • Phone: 716-982-2711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF311164-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: