Provider Demographics
NPI:1982140414
Name:SCHMIDT, ANGIE RENEE (FNP)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:RENEE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:RENEE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1617 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-9021
Mailing Address - Country:US
Mailing Address - Phone:984-215-6595
Mailing Address - Fax:
Practice Address - Street 1:1617 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-9021
Practice Address - Country:US
Practice Address - Phone:984-215-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-08
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010291363LF0000X
AZAP9665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily