Provider Demographics
NPI:1518115765
Name:SCHWERTLY, BRITTNEY LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:LOUISE
Last Name:SCHWERTLY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 CRESTMARK DR
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8538
Mailing Address - Country:US
Mailing Address - Phone:156-684-0604
Mailing Address - Fax:
Practice Address - Street 1:3700 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714
Practice Address - Country:US
Practice Address - Phone:812-485-4491
Practice Address - Fax:812-485-7344
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99048597A363A00000X
KYPA1153363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000580630OtherANTHEM BCBS
KY000000580630OtherANTHEM BCBS
KYP00682381Medicare PIN