Provider Demographics
NPI:1336490895
Name:SCHERMERHORN, JON ALAN (ACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:ALAN
Last Name:SCHERMERHORN
Suffix:
Gender:M
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 N TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:MORGANFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42437-1252
Mailing Address - Country:US
Mailing Address - Phone:270-559-4994
Mailing Address - Fax:
Practice Address - Street 1:506 N TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-1252
Practice Address - Country:US
Practice Address - Phone:270-559-4994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0000011004146N00000X
IN28148103A363LA2100X, 367A00000X
KY3007688363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife