Provider Demographics
NPI:1245628601
Name:SCHMIDTKE, CAROLINE TAYLOR (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:TAYLOR
Last Name:SCHMIDTKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 CANTON RD NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8948
Mailing Address - Country:US
Mailing Address - Phone:678-741-5000
Mailing Address - Fax:678-741-2301
Practice Address - Street 1:711 CANTON RD NE
Practice Address - Street 2:SUITE 300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8948
Practice Address - Country:US
Practice Address - Phone:678-741-5000
Practice Address - Fax:678-741-2301
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical