Provider Demographics
NPI:1639257082
Name:SCHMITZ, HOLLY R (RDLD)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:R
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:RDLD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:R
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2159 D RD
Mailing Address - Street 2:
Mailing Address - City:BAILEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66404-8400
Mailing Address - Country:US
Mailing Address - Phone:402-239-1758
Mailing Address - Fax:
Practice Address - Street 1:2159 D RD
Practice Address - Street 2:
Practice Address - City:BAILEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:66404-8400
Practice Address - Country:US
Practice Address - Phone:402-239-1758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1353133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1353OtherDIETICIAN LICENSE #