MEDICARE: SUZANNE SCHWAPPACH

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	164W00000X	Licensed Practical Nurse	L-34547-7	MN

General Provider Information

NPI Number	:	1821536616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE SCHWAPPACH

Provider Business Mailing Address
First Line	:	7084 100TH AVE SE
Second Line	:
City	:	CLEAR LAKE
State	:	MN
Zip	:	55319-9607
Country	:	US
Telephone Number	:	320-267-6016
Fax Number	:

Provider Business Practice Location Address
First Line	:	7084 100TH AVE SE
Second Line	:
City	:	CLEAR LAKE
State	:	MN
Zip	:	55319-9607
Country	:	US
Telephone Number	:	320-267-6016
Fax Number	:

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

Provider Enumeration Date	:	02/01/2017
Last Update Date	:	02/01/2017

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Directions to “ SUZANNE SCHWAPPACH ” Practice Location

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