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General NPI Number Information
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NPI Number | 1417645656
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Entity Type | Individual
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Provider Name | COURTNEY B SCHWOEBEL
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Gender | Female
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 100 N MARIO CAPECCHI DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84113-1103
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Country | US
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Telephone | 801-662-1000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 30180
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City | SALT LAKE CITY
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State | UT
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Zip | 84130-0180
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Country | US
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Telephone |
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 10380554-3102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 14067982-4405
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License Number State | UT
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