Provider Demographics
NPI:1164976551
Name:SCHMIDT, MARCY (PA-C)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:
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 1:433 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48853-5001
Mailing Address - Country:US
Mailing Address - Phone:517-667-9718
Mailing Address - Fax:
Practice Address - Street 1:805 S OAKLAND ST
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2253
Practice Address - Country:US
Practice Address - Phone:517-667-9718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601008122363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical