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NPI 1255024089

NPI 1255024089 : ALEXIS SCHMID CRNA : PHOENIX, AZ

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General NPI Number Information
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    NPI Number           |    1255024089
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXIS SCHMID CRNA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/29/2023
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    Last Update Date     |    03/07/2024
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Provider Practice Location Address
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    Address Line         |    4605 E ELWOOD ST STE 500 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85040-1978
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    Country              |    US
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    Telephone            |    480-256-1518
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2587 W TEMPLE ST 
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    City                 |    CHANDLER
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    State                |    AZ
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    Zip                  |    85224-7818
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    Country              |    US
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    Telephone            |    907-723-9273
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163W00000X
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    Taxonomy Name        |    Registered Nurse
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    License Number       |    8483114-3102
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    License Number State |    UT
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Taxonomy #2
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    294271
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    License Number State |    AZ
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