Provider Demographics
NPI:1184689796
Name:SCHMIDT, JENNIFER K (PA-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:OKAS, NALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1104 21ST ST
Mailing Address - Street 2:
Mailing Address - City:REEDSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53959-1156
Mailing Address - Country:US
Mailing Address - Phone:608-768-3900
Mailing Address - Fax:608-524-1870
Practice Address - Street 1:1104 21ST ST
Practice Address - Street 2:
Practice Address - City:REEDSBURG
Practice Address - State:WI
Practice Address - Zip Code:53959-1156
Practice Address - Country:US
Practice Address - Phone:608-768-3900
Practice Address - Fax:608-524-1870
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1771-023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI61425OtherDEAN HEALTH INSURANCE
WIP01315337Medicare PIN
WI741501977Medicare PIN