Basic Information
| Provider Information | |||||||||
| NPI: | 1699904888 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMIDT | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1751 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | COUNCIL BLUFFS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 515035246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7123288800 | ||||||||
| FaxNumber: | 7123288461 | ||||||||
| Practice Location | |||||||||
| Address1: | 1751 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | COUNCIL BLUFFS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 515035246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7123288800 | ||||||||
| FaxNumber: | 7123288461 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2009 | ||||||||
| LastUpdateDate: | 11/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | DO-04864 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.