Healthcare Provider Details

I. General information

NPI: 1356467039
Provider Name (Legal Business Name): JUDITH MAY SCHWARTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 28TH ST STE. 180
MINNEAPOLIS MN
55407-1139
US

IV. Provider business mailing address

7400 DELLWOOD RD N
MAHTOMEDI MN
55115-1456
US

V. Phone/Fax

Practice location:
  • Phone: 612-338-1100
  • Fax: 612-871-9580
Mailing address:
  • Phone: 612-338-1100
  • Fax: 612-871-9580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberR 071110 8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: