Provider Demographics
NPI:1477047454
Name:SCHMITT, CORRIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CORRIE
Middle Name:
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 LOUISIANA ST APT 206
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-4060
Mailing Address - Country:US
Mailing Address - Phone:413-896-5849
Mailing Address - Fax:
Practice Address - Street 1:3651 LOUISIANA ST APT 206
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-4060
Practice Address - Country:US
Practice Address - Phone:413-896-5849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily