Provider Demographics
NPI:1366573503
Name:SCHMIDT, CAROL MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:MARIE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MARION ST
Mailing Address - Street 2:
Mailing Address - City:SIGOURNEY
Mailing Address - State:IA
Mailing Address - Zip Code:52591-1443
Mailing Address - Country:US
Mailing Address - Phone:641-622-9133
Mailing Address - Fax:641-622-9134
Practice Address - Street 1:101 E MARION ST
Practice Address - Street 2:
Practice Address - City:SIGOURNEY
Practice Address - State:IA
Practice Address - Zip Code:52591-1443
Practice Address - Country:US
Practice Address - Phone:641-622-9133
Practice Address - Fax:641-622-9134
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA103223363LC0200X
IAA103233363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP06820Medicare UPIN