Provider Demographics
NPI:1396908083
Name:SCHMITZ, BRITTANY ACACIA (PA-C)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:ACACIA
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:ACACIA
Other - Last Name:RUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1825 LOGAN AVE
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-1916
Mailing Address - Country:US
Mailing Address - Phone:319-235-3697
Mailing Address - Fax:319-235-3844
Practice Address - Street 1:1825 LOGAN AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1916
Practice Address - Country:US
Practice Address - Phone:319-235-3697
Practice Address - Fax:319-235-3844
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001922363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA217700001Medicare PIN