Individual
MRS. SUSAN DISSELKOEN SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
215 S PARKSIDE DR STE 215, COLORADO SPRINGS, CO 80910-3131
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
91908
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01037765
—
CO
01
—
025437
KAISER COMMERCIAL NUMBER
CO
Enumeration date
09/09/2005
Last updated
06/21/2021
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