Provider Demographics
NPI:1063896595
Name:SCHMOLL, ANNA (OD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SCHMOLL
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 12TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-1614
Mailing Address - Country:US
Mailing Address - Phone:320-352-0146
Mailing Address - Fax:320-352-0023
Practice Address - Street 1:205 12TH ST S
Practice Address - Street 2:
Practice Address - City:SAUK CENTRE
Practice Address - State:MN
Practice Address - Zip Code:56378-1614
Practice Address - Country:US
Practice Address - Phone:320-352-0146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3443152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist