Provider Demographics
NPI:1336112655
Name:SCHMUTZLER, DONNA JEAN (CNM)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:JEAN
Last Name:SCHMUTZLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:JEAN
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:21979 BELL LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-7572
Mailing Address - Country:US
Mailing Address - Phone:479-789-5525
Mailing Address - Fax:
Practice Address - Street 1:1 CHOCTAW WAY
Practice Address - Street 2:
Practice Address - City:TALIHINA
Practice Address - State:OK
Practice Address - Zip Code:74571-2022
Practice Address - Country:US
Practice Address - Phone:918-567-7000
Practice Address - Fax:918-567-7044
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0074567367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP88454Medicare UPIN