Provider Demographics
NPI:1447214515
Name:SCHMIDT, JANE CAROL (RN CNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:CAROL
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 SOUTH SIBLEY AVE
Mailing Address - Street 2:AFFILIATED COMMUNITY MEDICAL CENTERS
Mailing Address - City:LITCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55355
Mailing Address - Country:US
Mailing Address - Phone:320-693-3233
Mailing Address - Fax:320-693-3290
Practice Address - Street 1:520 SOUTH SIBLEY AVE
Practice Address - Street 2:AFFILIATED COMMUNITY MEDICAL CENTERS
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355
Practice Address - Country:US
Practice Address - Phone:320-693-3233
Practice Address - Fax:320-693-3290
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR118105-4207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN023826100Medicaid
S46817Medicare UPIN