Provider Demographics
NPI:1346659992
Name:SCHWARTZ, KJERSTI L (NP)
Entity Type:Individual
Prefix:
First Name:KJERSTI
Middle Name:L
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KJERSTI
Other - Middle Name:
Other - Last Name:SIKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4193 CANINO CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6606 STADIUM DR
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7510
Practice Address - Country:US
Practice Address - Phone:813-779-8953
Practice Address - Fax:813-355-5081
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9448012363LP0808X, 363LF0000X
OR200741652RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500679423Medicaid
FL020871400Medicaid