MEDICARE: COLLEEN SCHMIDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	CP000845	SD
2	363LF0000X	Family Nurse Practitioner	CP000845	SD

General Provider Information

NPI Number	:	1447675640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN SCHMIDT

Provider Business Mailing Address
First Line	:	PO BOX 5074
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5074
Country	:	US
Telephone Number	:	605-328-6585
Fax Number	:	605-328-6512

Provider Business Practice Location Address
First Line	:	1309 W 17TH ST STE G01
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57104-4664
Country	:	US
Telephone Number	:	605-314-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2014
Last Update Date	:	07/27/2022

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Directions to “ COLLEEN SCHMIDT ” Practice Location

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