Healthcare Provider Details

I. General information

NPI: 1053220905
Provider Name (Legal Business Name): CHRISTINE MARIE SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E WARLOW DR SPC 72
GILLETTE WY
82716-3041
US

IV. Provider business mailing address

1801 E WARLOW DR SPC 72
GILLETTE WY
82716-3041
US

V. Phone/Fax

Practice location:
  • Phone: 307-670-4872
  • Fax:
Mailing address:
  • Phone: 307-670-4872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: