Individual
MARK RUSSELL SCHMITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1804 DIXIE DR., WAUKESHA, WI 53189
(126) 240-8216
Mailing address
1804 DIXIE DR., WAUKESHA, WI 53189
(262) 408-2167
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
161492-30
WI
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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