MEDICARE: PEGGY L SCHWARTZ ANP,MSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	87375-030	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114946548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY L SCHWARTZ ANP,MSN

Provider Business Mailing Address
First Line	:	1111 DELAFIELD ST STE 327
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53188-3417
Country	:	US
Telephone Number	:	262-524-1024
Fax Number	:	262-524-8767

Provider Business Practice Location Address
First Line	:	2301 SUN VALLEY DR STE 200
Second Line	:
City	:	DELAFIELD
State	:	WI
Zip	:	53018-2318
Country	:	US
Telephone Number	:	262-646-4162
Fax Number	:	262-646-2498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	12/26/2007

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