Provider Demographics
NPI:1164754479
Name:SCHMIDT, KATHLEEN (RN BSN CWOCN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:RN BSN CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 NORWEGIAN SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-9317
Mailing Address - Country:US
Mailing Address - Phone:724-822-7192
Mailing Address - Fax:
Practice Address - Street 1:764 NORWEGIAN SPRUCE DR
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-9317
Practice Address - Country:US
Practice Address - Phone:724-822-7192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN208454L163W00000X, 163WC2100X, 163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care