Provider Demographics
NPI:1992965495
Name:SCHMITZ, JENNA JANE (LM, CPM)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:JANE
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CRUSTON WAY
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2696
Mailing Address - Country:US
Mailing Address - Phone:207-615-2274
Mailing Address - Fax:
Practice Address - Street 1:4 CRUSTON WAY
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2696
Practice Address - Country:US
Practice Address - Phone:207-615-2274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT107.0106292176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife