Healthcare Provider Details

I. General information

NPI: 1245470830
Provider Name (Legal Business Name): JUDITH SCHARNAK R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 EAST US 36
AVON IN
46123
US

IV. Provider business mailing address

5087 SANDY CT.
PITTSBORO IN
46167
US

V. Phone/Fax

Practice location:
  • Phone: 317-272-3330
  • Fax:
Mailing address:
  • Phone: 317-501-1862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number28118876A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: