Provider Demographics
NPI:1508159286
Name:SCHMIDT, SUSAN LOUISE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LOUISE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:LOUISE
Other - Last Name:WESTBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2643 NORWICH ST.
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711
Mailing Address - Country:US
Mailing Address - Phone:608-271-2387
Mailing Address - Fax:
Practice Address - Street 1:2643 NORWICH ST.
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:608-271-2387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33348-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse