Healthcare Provider Details

I. General information

NPI: 1467804658
Provider Name (Legal Business Name): KAYLEIGH MARIE SCHWARTZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLEIGH HENDRICKS CPNP-PC

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 EAST MEDICAL CENTER 7TH FLOOR MED SUBSPECIALTY CLINIC
ANN ARBOR MI
48109-4257
US

IV. Provider business mailing address

3621 SOUTH STATE STREET 700 KMS PLACE
ANN ARBOR MI
48108
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-9814
  • Fax:
Mailing address:
  • Phone: 734-936-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4704299441
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: