Provider Demographics
NPI:1710688114
Name:SCHMIDT, TIA (CNP)
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1761
Mailing Address - Country:US
Mailing Address - Phone:740-779-6801
Mailing Address - Fax:740-779-6804
Practice Address - Street 1:201 N PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1761
Practice Address - Country:US
Practice Address - Phone:740-779-6801
Practice Address - Fax:740-779-6804
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032164363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner