Provider Demographics
NPI:1619591674
Name:SCHMIDT, REBECCA DIANNE (PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DIANNE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6741 KEOKUK AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-4305
Mailing Address - Country:US
Mailing Address - Phone:507-319-8290
Mailing Address - Fax:
Practice Address - Street 1:6741 KEOKUK AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-4305
Practice Address - Country:US
Practice Address - Phone:507-319-8290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP41413146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic