Provider Demographics
NPI:1073996997
Name:SCHEMM, LAURA E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:E
Last Name:SCHEMM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:RODDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:262-767-6020
Mailing Address - Fax:262-767-6023
Practice Address - Street 1:709 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-7614
Practice Address - Country:US
Practice Address - Phone:262-767-6020
Practice Address - Fax:262-767-6023
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3603-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100047152Medicaid