Basic Information
| Provider Information | |||||||||
| NPI: | 1457935926 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMUTZ | ||||||||
| FirstName: | ALEXANDRIA | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PA-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9047 DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | BLUFFTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458179542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198907772 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 770 W HIGH ST STE 350 | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458015901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192288950 | ||||||||
| FaxNumber: | 4192247904 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2021 | ||||||||
| LastUpdateDate: | 06/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 50007434RX | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.