MEDICARE: ANNA KRISTINE SCHMITT RN

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	R1613360	MN

General Provider Information

NPI Number	:	1760030142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA KRISTINE SCHMITT RN

Provider Business Mailing Address
First Line	:	2060 CENTRE POINTE BLVD STE 3
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55120-1271
Country	:	US
Telephone Number	:	763-862-7944
Fax Number	:

Provider Business Practice Location Address
First Line	:	2708 119TH AVE NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55433-2912
Country	:	US
Telephone Number	:	763-862-7944
Fax Number	:

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

Provider Enumeration Date	:	08/29/2019
Last Update Date	:	08/29/2019

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