Healthcare Provider Details

I. General information

NPI: 1588435499
Provider Name (Legal Business Name): AMANDA A SCHMELLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 W LOOMIS RD
FRANKLIN WI
53132-8030
US

IV. Provider business mailing address

W124S6648 HAWTHORNE RD
MUSKEGO WI
53150-3035
US

V. Phone/Fax

Practice location:
  • Phone: 414-488-1111
  • Fax:
Mailing address:
  • Phone: 262-229-5627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number14875
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: