MEDICARE: MS. MARY JOAN SCHOENWETTER APNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	54553	WI

General Provider Information

NPI Number	:	1194830570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY JOAN SCHOENWETTER APNP

Provider Business Mailing Address
First Line	:	652 SADDLE RDG
Second Line	:
City	:	PORTAGE
State	:	WI
Zip	:	53901-9701
Country	:	US
Telephone Number	:	608-742-1454
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 OVERLOOK TERRACE
Second Line	:	WM. S. MIDDLETON MEMORIAL VETERANS HOSPITAL
City	:	MADISON
State	:	WI
Zip	:	53705
Country	:	US
Telephone Number	:	608-256-1901
Fax Number	:	920-356-9477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/08/2007

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