Provider Demographics
NPI:1467108373
Name:SCHMIDT, MICHELLE (CRNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-5011
Mailing Address - Country:US
Mailing Address - Phone:941-280-9614
Mailing Address - Fax:941-480-1033
Practice Address - Street 1:20685 OVID LN
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-2289
Practice Address - Country:US
Practice Address - Phone:570-350-2845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025189363LP0808X
FL11017558363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health