MEDICARE: STEPHANIE SCHAGRIN APRN

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	363LF0000X	Family Nurse Practitioner	APRN11033481	FL
2	363LF0000X	Family Nurse Practitioner	SP024558	PA
3	363LA2200X	Adult Health Nurse Practitioner	APRN11033481	FL

General Provider Information

NPI Number	:	1962165217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SCHAGRIN APRN

Provider Business Mailing Address
First Line	:	770 W GRANADA BLVD STE 101
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5179
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 MEMORIAL MEDICAL PKWY STE 1-800A
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-5983
Country	:	US
Telephone Number	:	386-302-1365
Fax Number	:	386-302-1366

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

Provider Enumeration Date	:	10/14/2021
Last Update Date	:	01/12/2026

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