Provider Demographics
NPI:1902238629
Name:SCHMIDT, ISABEL A
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:A
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 BERGEN PKWY
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9522
Mailing Address - Country:US
Mailing Address - Phone:303-674-8246
Mailing Address - Fax:303-670-6840
Practice Address - Street 1:1173 BERGEN PKWY
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9522
Practice Address - Country:US
Practice Address - Phone:303-674-8246
Practice Address - Fax:303-670-6840
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist