Provider Demographics
NPI:1407652670
Name:SCHMITZ, HOLLIE
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:
Last Name:SCHMITZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:HOLLIE
Other - Middle Name:
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1103 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-9008
Mailing Address - Country:US
Mailing Address - Phone:262-989-6404
Mailing Address - Fax:
Practice Address - Street 1:1031 MARYLAND AVE UNIT 123
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4908
Practice Address - Country:US
Practice Address - Phone:920-838-2890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23517530163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse