Provider Demographics
NPI:1629054044
Name:SCHMITT, JOHNALLEN F (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JOHNALLEN
Middle Name:F
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 PLAZA DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-2916
Mailing Address - Country:US
Mailing Address - Phone:812-348-4000
Mailing Address - Fax:812-376-0678
Practice Address - Street 1:2400 17TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5351
Practice Address - Country:US
Practice Address - Phone:812-348-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-17
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002032A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200920710Medicaid
IN000000983416OtherANTHEM PIN
IN200920710Medicaid