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NPI 1619591674

NPI 1619591674 : REBECCA DIANNE SCHMIDT PARAMEDIC : WINNETKA, CA

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General NPI Number Information
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    NPI Number           |    1619591674
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA DIANNE SCHMIDT PARAMEDIC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/04/2020
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    Last Update Date     |    06/04/2020
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Provider Practice Location Address
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    Address Line         |    6741 KEOKUK AVE 
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    City                 |    WINNETKA
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    State                |    CA
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    Zip                  |    91306-4305
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    Country              |    US
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    Telephone            |    507-319-8290
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6741 KEOKUK AVE 
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    City                 |    WINNETKA
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    State                |    CA
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    Zip                  |    91306-4305
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    Country              |    US
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    Telephone            |    507-319-8290
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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        |    146L00000X
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    Taxonomy Name        |    Paramedic
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    License Number       |    P41413
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    License Number State |    CA
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