Provider Demographics
NPI:1659544914
Name:SCHWARTZ, SHERRY L (RN BSN BC FNP)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:RN BSN BC FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-2540
Mailing Address - Country:US
Mailing Address - Phone:660-827-2500
Mailing Address - Fax:660-827-2511
Practice Address - Street 1:3700 W 10TH ST
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2540
Practice Address - Country:US
Practice Address - Phone:660-827-2500
Practice Address - Fax:573-557-2401
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003001866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO429220908Medicaid
MO2003001866OtherLICENSE