1073683611 NPI number — MRS. KRYSTEN LEIGH SCHMIDT FNP

Table of content: MRS. KRYSTEN LEIGH SCHMIDT FNP (NPI 1073683611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073683611 NPI number — MRS. KRYSTEN LEIGH SCHMIDT FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMIDT
Provider First Name:
KRYSTEN
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
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:
1073683611
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 BANK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATAVIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14020-2216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-343-6600
Provider Business Mailing Address Fax Number:
585-343-6601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 BANK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATAVIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-343-6600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2006

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: 363LF0000X , with the licence number:  F3344081 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000926461002 . This is a "BLUE SHIELD WNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00027364501 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02629270 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030441930 . This is a "AETNA, TRICARE, UNITED HE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 143259CK . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9513031 . This is a "INDEPENDANT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PO1933408 . This is a "BLUE CHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P020216110 . This is a "BLUE CTOSS OF ROCHESTER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com