Provider Demographics
NPI:1376840124
Name:SCHMIDT, LEAH ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:ANN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 SOUTHTOWNE DRIVE
Mailing Address - Street 2:APARTMENT H 205
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172
Mailing Address - Country:US
Mailing Address - Phone:920-819-9187
Mailing Address - Fax:
Practice Address - Street 1:414 SOUTHTOWNE DRIVE
Practice Address - Street 2:205
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172
Practice Address - Country:US
Practice Address - Phone:920-819-9187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI311845/031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse