Basic Information
Provider Information
NPI: 1285067694
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMIDT
FirstName: NATALIE
MiddleName: SUZANN
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 270 N MAIN ST
Address2: STE 300
City: STILLWATER
State: MN
PostalCode: 550826788
CountryCode: US
TelephoneNumber: 6513421039
FaxNumber: 6513421428
Practice Location
Address1: 270 N MAIN ST
Address2: STE 300
City: STILLWATER
State: MN
PostalCode: 550826788
CountryCode: US
TelephoneNumber: 6513421039
FaxNumber: 6513421428
Other Information
ProviderEnumerationDate: 08/21/2013
LastUpdateDate: 03/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP2300XCNP 0440MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care

ID Information
IDTypeStateIssuerDescription
CNP 044001MNAPRN LICENSEOTHER


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