Provider Demographics
NPI:1154870640
Name:SCHMITZ, TAMALA (CNP)
Entity type:Individual
Prefix:
First Name:TAMALA
Middle Name:
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56241-1442
Mailing Address - Country:US
Mailing Address - Phone:320-564-3111
Mailing Address - Fax:320-313-3386
Practice Address - Street 1:345 10TH AVE
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56241-1442
Practice Address - Country:US
Practice Address - Phone:320-564-3111
Practice Address - Fax:320-313-3386
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP4815363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily