Provider Demographics
NPI:1982630778
Name:SCHMIDT KONEN, CARRIE A (DNP, MBA, MSN, APRN,)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:A
Last Name:SCHMIDT KONEN
Suffix:
Gender:F
Credentials:DNP, MBA, MSN, APRN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 HUNTER CREST DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-0002
Mailing Address - Country:US
Mailing Address - Phone:405-635-4123
Mailing Address - Fax:888-972-2905
Practice Address - Street 1:3217 HUNTER CREST DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-0002
Practice Address - Country:US
Practice Address - Phone:405-635-4123
Practice Address - Fax:888-972-2905
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45871363L00000X, 363LP0808X
ARA004355363L00000X
MO2013042737363L00000X
TXAP127903363L00000X, 363LP0808X
OK116257363L00000X
CT10822363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT10822OtherBOARD OF NURSING