Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 55748 | WI |
N | 111NI0900X | Internist | 55748 | WI |
Y | 207RH0003X | Hematology & Oncology | 55748 | WI |
NPI | 1033351465 |
---|---|
Provider Name | Mrs. Shannon Leah Schmidt |
First Address | Appleton, WI 54912-8003 |
Second Address | Appleton, WI 54911-8735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2009 |
Last Update Date | 01/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
K400321103 | MEDICARE PTAN (01) | WI |
K400321104 | MEDICARE PTAN (01) | WI |
K400321105 | MEDICARE PTAN (01) | WI |