Healthcare Provider Details

I. General information

NPI: 1346780558
Provider Name (Legal Business Name): NICOLE MARIE SCHWANZER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE MARIE WISHON APRN

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12271 US HIGHWAY 301 N
PARRISH FL
34219-8410
US

IV. Provider business mailing address

11000 OPTUM CIRCLE
EDEN PRAIRIE MN
55344
US

V. Phone/Fax

Practice location:
  • Phone: 941-776-4050
  • Fax: 941-776-4057
Mailing address:
  • Phone: 941-776-4000
  • Fax: 941-845-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9288506
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: