Provider Demographics
NPI:1679294151
Name:SCHMID, ANNA CHRISTINA (PTA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINA
Last Name:SCHMID
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-5641
Mailing Address - Country:US
Mailing Address - Phone:573-291-3882
Mailing Address - Fax:
Practice Address - Street 1:1306 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1356
Practice Address - Country:US
Practice Address - Phone:573-635-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018037412225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4208Medicaid