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General NPI Number Information
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NPI Number | 1750262143
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Entity Type | Individual
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Provider Name | JESSICA ELIZABETH SCHOENROCK
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1155 W PARKVIEW ST
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City | BOLIVAR
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State | MO
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Zip | 65613-7801
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Country | US
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Telephone | 417-326-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 3398 W ROXBURY ST
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City | SPRINGFIELD
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State | MO
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Zip | 65807-8226
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Country | US
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Telephone | 910-964-8694
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F07251197
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License Number State | MO
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