Provider Demographics
NPI:1225506975
Name:SCHOONOVER, MERCEDES (FNP-C)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MERCEDES
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1802 4TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2308
Mailing Address - Country:US
Mailing Address - Phone:304-960-9739
Mailing Address - Fax:
Practice Address - Street 1:5296 REDBUD HWY
Practice Address - Street 2:
Practice Address - City:HONAKER
Practice Address - State:VA
Practice Address - Zip Code:24260-7379
Practice Address - Country:US
Practice Address - Phone:276-991-9500
Practice Address - Fax:276-991-4399
Is Sole Proprietor?:No
Enumeration Date:2018-11-10
Last Update Date:2018-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001238291163W00000X
VA0024176875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse