=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790034155
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LADIES FIRST KRYSTEN SCHMIDT NURSE PRACTITIONER IN FAMILY HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2012
-----------------------------------------------------
Last Update Date | 05/24/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 108 BANK ST
-----------------------------------------------------
City | BATAVIA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-343-6600
-----------------------------------------------------
Fax | 585-343-6601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 108 BANK ST
-----------------------------------------------------
City | BATAVIA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14020-2216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-343-6600
-----------------------------------------------------
Fax | 585-343-6601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FNP
-----------------------------------------------------
Name | KRYSTEN SCHMIDT
-----------------------------------------------------
Credential | FNP
-----------------------------------------------------
Telephone | 585-356-3467
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F3344081
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------