MEDICARE: NICOLE SCHMIDT FNP-C

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	APRN.CNP.0031022	OH

General Provider Information

NPI Number	:	1588309934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE SCHMIDT FNP-C

Provider Business Mailing Address
First Line	:	8647 CHARLESTON KNOLL CT
Second Line	:
City	:	MASON
State	:	OH
Zip	:	45040-8598
Country	:	US
Telephone Number	:	513-582-1067
Fax Number	:

Provider Business Practice Location Address
First Line	:	7763 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-4201
Country	:	US
Telephone Number	:	513-891-5438
Fax Number	:

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

Provider Enumeration Date	:	04/30/2022
Last Update Date	:	04/30/2022

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