Healthcare Provider Details

I. General information

NPI: 1912396201
Provider Name (Legal Business Name): ERIC ESCHWEILER DNP, RN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2015
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 N D ST
SAN BERNARDINO CA
92401-1352
US

IV. Provider business mailing address

590 N D ST
SAN BERNARDINO CA
92401-1352
US

V. Phone/Fax

Practice location:
  • Phone: 909-326-0007
  • Fax:
Mailing address:
  • Phone: 909-326-0007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: