Healthcare Provider Details

I. General information

NPI: 1720238918
Provider Name (Legal Business Name): KERI SCHWARTZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10121 PINE AVE
TRUCKEE CA
96161-4856
US

IV. Provider business mailing address

1177 E.FRANCISCO BLVD. SUITE B
SAN RAFAEL CA
94901
US

V. Phone/Fax

Practice location:
  • Phone: 530-587-0611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60047639
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP20353
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number20535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: