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NPI Code Detail

MEDICARE: JOHN MICHAEL SHOLAR PMHNP

MEDICARE: JOHN MICHAEL SHOLAR PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner200450071NPOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200450071NPOTHERORBOARD NURSING

General Provider Information

NPI Number : 1437112885
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MICHAEL SHOLAR PMHNP
Provider Business Mailing Address
First Line : 1118 OAK ST SE
Second Line :
City : SALEM
State : OR
Zip : 97301-4019
Country : US
Telephone Number : 504-585-4949
Fax Number : 503-585-4965
Provider Business Practice Location Address
First Line : 1118 OAK ST SE
Second Line :
City : SALEM
State : OR
Zip : 97301-4019
Country : US
Telephone Number : 503-585-4949
Fax Number : 503-585-4965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2006
Last Update Date : 03/07/2023

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