Provider Demographics
NPI:1093327710
Name:SCHMIDT, KIRSTEN MARIE (LPTA)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MARIE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 FROSTY RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-2915
Mailing Address - Country:US
Mailing Address - Phone:757-284-6823
Mailing Address - Fax:
Practice Address - Street 1:1213 FROSTY RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-2915
Practice Address - Country:US
Practice Address - Phone:757-284-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306000922225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant