Healthcare Provider Details

I. General information

NPI: 1942790837
Provider Name (Legal Business Name): NICOLE GABRIELLE SCHMIDT APRN.CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 W LONG ST
COLUMBUS OH
43215-2815
US

IV. Provider business mailing address

637 MEADOWS DR
DELAWARE OH
43015-8161
US

V. Phone/Fax

Practice location:
  • Phone: 614-225-0980
  • Fax:
Mailing address:
  • Phone: 614-928-7686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number366366
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number00022942
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: