Provider Demographics
NPI:1861218950
Name:SCHMIEGE, DIANNE MARIE
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:MARIE
Last Name:SCHMIEGE
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 1:1672 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-9180
Mailing Address - Country:US
Mailing Address - Phone:989-892-3438
Mailing Address - Fax:989-892-3438
Practice Address - Street 1:772 N SCHEURMANN RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-9181
Practice Address - Country:US
Practice Address - Phone:989-233-4017
Practice Address - Fax:989-892-3438
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM0902788063104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness