MEDICARE: SANDY LEE SCHMITZ FNP

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	363LP2300X	Primary Care Nurse Practitioner	AP.1000465-NP	CO

General Provider Information

NPI Number	:	1942011002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDY LEE SCHMITZ FNP

Provider Business Mailing Address
First Line	:	13120 BRIDLE BIT RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80908-3272
Country	:	US
Telephone Number	:	562-412-2618
Fax Number	:

Provider Business Practice Location Address
First Line	:	13120 BRIDLE BIT RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80908-3272
Country	:	US
Telephone Number	:	562-412-2618
Fax Number	:

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

Provider Enumeration Date	:	01/17/2025
Last Update Date	:	01/17/2025

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