Healthcare Provider Details

I. General information

NPI: 1659372472
Provider Name (Legal Business Name): JEANANN SCHWARK MS, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8070 E MORGAN TRL SUITE 120
SCOTTSDALE AZ
85258-1227
US

IV. Provider business mailing address

8070 E MORGAN TRL SUITE 120
SCOTTSDALE AZ
85258-1227
US

V. Phone/Fax

Practice location:
  • Phone: 480-825-7941
  • Fax: 480-825-7945
Mailing address:
  • Phone: 480-825-7941
  • Fax: 480-825-7945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1637
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP1637
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: