1073513867 NPI number — CINDY D SCHMELTZ DNP, CRNP

Table of content: CINDY D SCHMELTZ DNP, CRNP (NPI 1073513867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073513867 NPI number — CINDY D SCHMELTZ DNP, CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMELTZ
Provider First Name:
CINDY
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DNP, CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073513867
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1610 MEDICAL DR
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
POTTSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19464-3292
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-327-4200
Provider Business Mailing Address Fax Number:
610-327-8160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 2ND AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
COLLEGEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19426-3600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-454-7750
Provider Business Practice Location Address Fax Number:
610-454-1367
Provider Enumeration Date:
07/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  TP004375B , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1016111110004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1643541 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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