Healthcare Provider Details

I. General information

NPI: 1326430075
Provider Name (Legal Business Name): LEANN SCHWEDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 BAY CITY RD
MIDLAND MI
48642-6014
US

IV. Provider business mailing address

4230 BAY CITY RD
MIDLAND MI
48642-6014
US

V. Phone/Fax

Practice location:
  • Phone: 989-839-0750
  • Fax: 989-839-9037
Mailing address:
  • Phone: 989-839-0750
  • Fax: 989-839-9037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704266146
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: