Provider Demographics
NPI:1104061571
Name:SCHMOLINSKE, ABBEY LEE (CRNA)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:LEE
Last Name:SCHMOLINSKE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ABBEY
Other - Middle Name:LEE
Other - Last Name:HEINDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:744 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3505
Practice Address - Country:US
Practice Address - Phone:920-433-5582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI133820-030367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00736468Medicare Oscar/Certification
WI520049Medicare Oscar/Certification
WI000089Medicare Oscar/Certification