Provider Demographics
NPI:1154435469
Name:SCHMIDT, ELLEN RENEE (NP)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:RENEE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX SURG
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-0876
Mailing Address - Fax:585-276-2203
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX SURG
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-0876
Practice Address - Fax:585-276-2203
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY300590363L00000X
NYF300590363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner