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General NPI Number Information
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NPI Number | 1225506975
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Entity Type | Individual
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Provider Name | MERCEDES SCHOONOVER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/10/2018
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Last Update Date | 11/10/2018
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Provider Practice Location Address
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Address Line | 5296 REDBUD HWY
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City | HONAKER
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State | VA
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Zip | 24260-7379
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Country | US
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Telephone | 276-991-9500
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Fax | 276-991-4399
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Provider Business Mailing Address
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Address Line | 1802 4TH ST
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City | RICHLANDS
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State | VA
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Zip | 24641-2308
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Country | US
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Telephone | 304-960-9739
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001238291
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024176875
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License Number State | VA
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