Provider Demographics
NPI:1649657222
Name:SCHMIDT, JACQUELINE MARIE (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARIE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1577 GOODMAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1044
Mailing Address - Country:US
Mailing Address - Phone:513-521-3600
Mailing Address - Fax:513-521-6403
Practice Address - Street 1:1577 GOODMAN AVE STE A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1044
Practice Address - Country:US
Practice Address - Phone:513-521-3600
Practice Address - Fax:513-521-6403
Is Sole Proprietor?:No
Enumeration Date:2015-05-02
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1106120163W00000X
IN28219340A163W00000X
OH282576163W00000X
MI4704228417163W00000X
IN71005621A363LF0000X
IN71005621B363LF0000X
KY3009730363LF0000X
OH18635NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse