Healthcare Provider Details

I. General information

NPI: 1336490895
Provider Name (Legal Business Name): JON ALAN SCHERMERHORN ACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 03/17/2023
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 N TOWNSEND ST
MORGANFIELD KY
42437-1252
US

IV. Provider business mailing address

506 N TOWNSEND ST
MORGANFIELD KY
42437-1252
US

V. Phone/Fax

Practice location:
  • Phone: 270-559-4994
  • Fax:
Mailing address:
  • Phone: 270-559-4994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3007688
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number28148103A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3007688
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number28148103A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number0000011004
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: