Provider Demographics
NPI:1073683611
Name:SCHMIDT, KRYSTEN LEIGH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTEN
Middle Name:LEIGH
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BANK ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2216
Mailing Address - Country:US
Mailing Address - Phone:585-343-6600
Mailing Address - Fax:585-343-6601
Practice Address - Street 1:108 BANK ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020
Practice Address - Country:US
Practice Address - Phone:585-343-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3344081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000926461002OtherBLUE SHIELD WNY
NY00027364501OtherUNIVERA
NY02629270Medicaid
NY030441930OtherAETNA, TRICARE, UNITED HE
NY143259CKOtherPREFERRED CARE
NY9513031OtherINDEPENDANT HEALTH
NYPO1933408OtherBLUE CHOICE
NYP020216110OtherBLUE CTOSS OF ROCHESTER