Provider Demographics
NPI:1679102974
Name:SCHMITT, TRACI (RPH)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 NW ARTERIAL
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-0496
Mailing Address - Country:US
Mailing Address - Phone:563-582-3436
Mailing Address - Fax:563-583-3282
Practice Address - Street 1:2395 NW ARTERIAL
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-0496
Practice Address - Country:US
Practice Address - Phone:563-582-3436
Practice Address - Fax:563-583-3282
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist