Provider Demographics
NPI:1427505486
Name:SCHMIDT, TOMI (RN)
Entity type:Individual
Prefix:
First Name:TOMI
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 LIEBMAN CT
Mailing Address - Street 2:APT 7
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54302-5089
Mailing Address - Country:US
Mailing Address - Phone:715-853-5870
Mailing Address - Fax:
Practice Address - Street 1:800 LIEBMAN CT
Practice Address - Street 2:APT 7
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54302-5089
Practice Address - Country:US
Practice Address - Phone:715-853-5870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI172375-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse