Healthcare Provider Details

I. General information

NPI: 1558911263
Provider Name (Legal Business Name): ABIGAIL MYREE SCHWARTZ CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL MYREE NOBLE CPNP

II. Dates (important events)

Enumeration Date: 09/14/2019
Last Update Date: 09/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4687 POUNCEY TRACT RD
GLEN ALLEN VA
23059-5802
US

IV. Provider business mailing address

4404 CARY STREET RD
RICHMOND VA
23221-2521
US

V. Phone/Fax

Practice location:
  • Phone: 804-422-5437
  • Fax:
Mailing address:
  • Phone: 540-521-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024177873
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: