Provider Demographics
NPI:1417932856
Name:SCHENTRUP, DENISE M (MN, ARNP, BC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:SCHENTRUP
Suffix:
Gender:F
Credentials:MN, ARNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16939 SW 134TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARCHER
Mailing Address - State:FL
Mailing Address - Zip Code:32618-5413
Mailing Address - Country:US
Mailing Address - Phone:352-495-2550
Mailing Address - Fax:352-495-3401
Practice Address - Street 1:16939 SW 134TH AVE
Practice Address - Street 2:
Practice Address - City:ARCHER
Practice Address - State:FL
Practice Address - Zip Code:32618-5413
Practice Address - Country:US
Practice Address - Phone:352-495-2550
Practice Address - Fax:352-495-3401
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2729982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302049500Medicaid
FLP42549Medicare UPIN
FLY0323YMedicare ID - Type Unspecified