Healthcare Provider Details

I. General information

NPI: 1811172836
Provider Name (Legal Business Name): JAZZCELYN L SCHERTZ DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAZZCELYN GOMEZ LOLENG FNP-BC

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15740 S OUTER 40 RD
CHESTERFIELD MO
63017-2004
US

IV. Provider business mailing address

228 EGRET CT
BELLEVILLE IL
62223-3259
US

V. Phone/Fax

Practice location:
  • Phone: 636-735-4755
  • Fax:
Mailing address:
  • Phone: 618-792-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number209006430
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2018022344
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: