Provider Demographics
NPI:1104540517
Name:SCHMIDT, CRYSTAL RENEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:RENEE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 19E BYP
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-4676
Mailing Address - Country:US
Mailing Address - Phone:423-542-4133
Mailing Address - Fax:423-542-3874
Practice Address - Street 1:1641 19E BYP
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-4676
Practice Address - Country:US
Practice Address - Phone:423-542-4133
Practice Address - Fax:423-542-3874
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCSCHM-LHOFX363LF0000X
TN128295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily