Provider Demographics
NPI:1508862202
Name:SCHMIDT, LISA M (ARNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21890
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4115
Mailing Address - Country:US
Mailing Address - Phone:502-907-0356
Mailing Address - Fax:502-919-9780
Practice Address - Street 1:3602 NORTHGATE CT STE 39
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6417
Practice Address - Country:US
Practice Address - Phone:812-670-5684
Practice Address - Fax:812-941-0814
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3004000363LF0000X
IN71004352A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000359142OtherANTHEM
IN201273770Medicaid
INP02119880OtherRAILROAD MEDICARE
KYP02119882OtherRAILROAD MEDICARE
KY1700187OtherWELLCARE OF KENTUCKY PROVIDER ID NUMBER
KY313020KYIPOtherAETNA BETTER HEALTH OF KENTUCKY PROVIDER ID NUMBER
KY78012416Medicaid
CS1833200386OtherCARESOURCE ID