Provider Demographics
NPI:1639105653
Name:SCHMITZ, SUSAN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:SCHMITZ
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 1:23794 LAMPLIGHTER RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:WI
Mailing Address - Zip Code:54648-8211
Mailing Address - Country:US
Mailing Address - Phone:608-654-5800
Mailing Address - Fax:
Practice Address - Street 1:500 E VETERANS ST
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-3105
Practice Address - Country:US
Practice Address - Phone:608-372-1182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health