Healthcare Provider Details

I. General information

NPI: 1558757468
Provider Name (Legal Business Name): DAWN SCHUETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 01/05/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 S CLARK ST SUITE C
MEXICO MO
65265-4104
US

IV. Provider business mailing address

PO BOX 1027
JEFFERSON CITY MO
65102-1027
US

V. Phone/Fax

Practice location:
  • Phone: 573-582-0850
  • Fax: 573-582-0854
Mailing address:
  • Phone: 573-681-3767
  • Fax: 573-761-6947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2015006321
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: