Healthcare Provider Details

I. General information

NPI: 1417932856
Provider Name (Legal Business Name): DENISE M SCHENTRUP MN, ARNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16939 SW 134TH AVE
ARCHER FL
32618-5413
US

IV. Provider business mailing address

16939 SW 134TH AVE
ARCHER FL
32618-5413
US

V. Phone/Fax

Practice location:
  • Phone: 352-495-2550
  • Fax: 352-495-3401
Mailing address:
  • Phone: 352-495-2550
  • Fax: 352-495-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2729982
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: