Provider Demographics
NPI:1578231049
Name:SCHMIDT, KATHERINE THERESA (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:THERESA
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 RICHARD LN
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4145
Mailing Address - Country:US
Mailing Address - Phone:267-978-7143
Mailing Address - Fax:
Practice Address - Street 1:7800 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3812
Practice Address - Country:US
Practice Address - Phone:215-722-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023993363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health