Provider Demographics
NPI:1023041977
Name:SCHMIDT, JODIE DEMAY (ARNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:DEMAY
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 BRYN MAWR AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4333
Mailing Address - Country:US
Mailing Address - Phone:863-676-3411
Mailing Address - Fax:863-676-1015
Practice Address - Street 1:1109 BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4333
Practice Address - Country:US
Practice Address - Phone:863-676-3411
Practice Address - Fax:863-676-1015
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1190452363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS80830Medicare UPIN
FLE2562ZMedicare ID - Type Unspecified