Provider Demographics
NPI:1508813429
Name:SCHMIDT, LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2086 GULF TO BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3714
Mailing Address - Country:US
Mailing Address - Phone:727-462-0100
Mailing Address - Fax:727-462-0177
Practice Address - Street 1:2086 GULF TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3714
Practice Address - Country:US
Practice Address - Phone:727-462-0100
Practice Address - Fax:727-462-0177
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2139182363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY084POtherBLUE CROSS BLUE SHIELD
FL307252500Medicaid