Healthcare Provider Details

I. General information

NPI: 1730398272
Provider Name (Legal Business Name): LYNN JANICE SCHWARZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 WESTERN AVE
AUGUSTA ME
04330-7227
US

IV. Provider business mailing address

89 WESTERN AVE
AUGUSTA ME
04330-7227
US

V. Phone/Fax

Practice location:
  • Phone: 207-622-3355
  • Fax:
Mailing address:
  • Phone: 207-622-3355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR020492
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: