Healthcare Provider Details

I. General information

NPI: 1760055164
Provider Name (Legal Business Name): MICHELLE ELIZABETH SCHWARZ APRN-CNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10050 KENNERLY RD STE 2400
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

2613 JOYCERIDGE DR
CHESTERFIELD MO
63017-7118
US

V. Phone/Fax

Practice location:
  • Phone: 314-849-6066
  • Fax:
Mailing address:
  • Phone: 314-578-2613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021019713
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: