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1194137059 NPI number — SHELLEY ANNE SCHERTZER NP

NPI Number: 1194137059
Health Care Provider/Practitioner: SHELLEY ANNE SCHERTZER NP

Information about “1194137059” NPI (SHELLEY ANNE SCHERTZER NP) exists in 1194137059 in HTML format HTML  |  1194137059 in plain Text format TXT  |  1194137059 in PDF (Portable Document Format) PDF  |  1194137059 in an XML format XML  formats.

NPI Number : 1194137059 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194137059",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SCHERTZER",
    "FirstName": "SHELLEY",
    "MiddleName": "ANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GALLAGHER",
    "OtherFirstName": "SHELLEY",
    "OtherMiddleName": "ANNE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "483 CENTURY LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOLLAND",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49423-4286",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "616-396-5284",
    "MailingAddressFaxNumber": "616-396-8387",
    "FirstLinePracticeLocationAddress": "483 CENTURY LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOLLAND",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49423-4286",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "616-842-6710",
    "PracticeLocationAddressFaxNumber": "616-842-1103",
    "EnumerationDate": "05/27/2014",
    "LastUpdateDate": "02/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "4704247038",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207QA0401X",
          "TaxonomyName": "Addiction Medicine (Family Medicine) Physician",
          "LicenseNumber": "4704247038",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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