Provider Demographics
NPI:1558891366
Name:SCHMISEK, KRISTIE ANN (RN)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:ANN
Last Name:SCHMISEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8640 EAGLE CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-4400
Mailing Address - Country:US
Mailing Address - Phone:612-872-2001
Mailing Address - Fax:612-871-1375
Practice Address - Street 1:8640 EAGLE CREEK CIR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4400
Practice Address - Country:US
Practice Address - Phone:952-283-2799
Practice Address - Fax:952-746-0582
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN244286-0163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health