Provider Demographics
NPI:1043244775
Name:SCHMIDT, SHELLEY JANENE (ARNP-C)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:JANENE
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 1:2701 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-1722
Mailing Address - Country:US
Mailing Address - Phone:785-432-1552
Mailing Address - Fax:785-625-5759
Practice Address - Street 1:207 E 7TH ST # B
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-4133
Practice Address - Country:US
Practice Address - Phone:888-878-6881
Practice Address - Fax:785-625-5759
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSS39447Medicare UPIN
KS161275Medicare ID - Type UnspecifiedKANSAS MEDICARE PROVIDER