Provider Demographics
NPI:1366020158
Name:SCHMIDT, KRISTINA (RN, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:RN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:SUNDERLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05250-9783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2801 NORTH RD
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:VT
Practice Address - Zip Code:05250-9783
Practice Address - Country:US
Practice Address - Phone:802-379-4362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
VT026.0029598163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach