Provider Demographics
NPI:1093807547
Name:SCHMIDT, MARJORIE A (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:A
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:NE
Mailing Address - Zip Code:69343-1132
Mailing Address - Country:US
Mailing Address - Phone:308-282-1442
Mailing Address - Fax:308-282-1428
Practice Address - Street 1:807 N ASH ST
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:NE
Practice Address - Zip Code:69343-1132
Practice Address - Country:US
Practice Address - Phone:308-282-1442
Practice Address - Fax:308-282-1428
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE655363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE6288OtherMIDLANDS CHOICE
NE37367OtherBCBS
NENE655Medicaid
NES09293Medicare UPIN
NENE655Medicaid