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NPI Code Detail

MEDICARE: JESSE SCHWANGER CNP

MEDICARE: JESSE SCHWANGER CNP
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
1363LF0000XFamily Nurse Practitioner021958OH

General Provider Information

NPI Number : 1730693375
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE SCHWANGER CNP
Provider Business Mailing Address
First Line : 30791 DETROIT RD
Second Line :
City : WESTLAKE
State : OH
Zip : 44145-1835
Country : US
Telephone Number : 419-357-1194
Fax Number :
Provider Business Practice Location Address
First Line : 30791 DETROIT RD
Second Line :
City : WESTLAKE
State : OH
Zip : 44145-1835
Country : US
Telephone Number : 419-357-1194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2017
Last Update Date : 03/27/2018

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