Provider Demographics
NPI: | 1144419318 |
---|---|
Name: | SCHMIDT, ANNE MARIE (APRN CNS) |
Entity Type: | Individual |
Prefix: | |
First Name: | ANNE |
Middle Name: | MARIE |
Last Name: | SCHMIDT |
Suffix: | |
Gender: | F |
Credentials: | APRN CNS |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 802 S JACKSON AVE STE 301 |
Mailing Address - Street 2: | |
Mailing Address - City: | TULSA |
Mailing Address - State: | OK |
Mailing Address - Zip Code: | 74127-9057 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 918-582-3154 |
Mailing Address - Fax: | 918-582-3593 |
Practice Address - Street 1: | 6465 S YALE AVE STE 401 |
Practice Address - Street 2: | |
Practice Address - City: | TULSA |
Practice Address - State: | OK |
Practice Address - Zip Code: | 74136-7806 |
Practice Address - Country: | US |
Practice Address - Phone: | 918-561-6141 |
Practice Address - Fax: | 918-582-3593 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-10-23 |
Last Update Date: | 2023-07-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OK | 80562 | 364S00000X |
OK | R80562 | 363L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 364S00000X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OK | 80562 | Other | RN LICENSES |