Provider Demographics
NPI:1548604754
Name:SCHMITZ, KAISA ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:KAISA
Middle Name:ELIZABETH
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAISA
Other - Middle Name:
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:6350 W 143RD ST
Practice Address - Street 2:STE. 102
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2891
Practice Address - Country:US
Practice Address - Phone:952-428-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN58072207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine