Healthcare Provider Details

I. General information

NPI: 1649657222
Provider Name (Legal Business Name): JACQUELINE MARIE SCHMIDT MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2015
Last Update Date: 06/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 GOODMAN AVE STE A
CINCINNATI OH
45224-1044
US

IV. Provider business mailing address

1577 GOODMAN AVE STE A
CINCINNATI OH
45224-1044
US

V. Phone/Fax

Practice location:
  • Phone: 513-521-3600
  • Fax: 513-521-6403
Mailing address:
  • Phone: 513-521-3600
  • Fax: 513-521-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005621A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005621B
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3009730
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18635NP
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1106120
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28219340A
License Number StateIN
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number282576
License Number StateOH
# 8
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704228417
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: