Provider Demographics
NPI:1609480284
Name:SCHMIDT, CAROLYN (RDN)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11433 CODY ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3497
Mailing Address - Country:US
Mailing Address - Phone:913-424-4416
Mailing Address - Fax:
Practice Address - Street 1:11433 CODY ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-3497
Practice Address - Country:US
Practice Address - Phone:913-424-4416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered