Healthcare Provider Details

I. General information

NPI: 1154248953
Provider Name (Legal Business Name): BRIANNA M SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S STATE ST
SYRACUSE NY
13202-2280
US

IV. Provider business mailing address

168 BERESFORD LN
MINOA NY
13116-1950
US

V. Phone/Fax

Practice location:
  • Phone: 315-435-1770
  • Fax:
Mailing address:
  • Phone: 315-317-8285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF360019-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: