Provider Demographics
NPI:1558905471
Name:SCHERZ, CARLY LANE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:LANE
Last Name:SCHERZ
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 1:250 STATE ROAD 37
Mailing Address - Street 2:
Mailing Address - City:MONDOVI
Mailing Address - State:WI
Mailing Address - Zip Code:54755-2611
Mailing Address - Country:US
Mailing Address - Phone:715-926-6230
Mailing Address - Fax:
Practice Address - Street 1:250 STATE ROAD 37
Practice Address - Street 2:
Practice Address - City:MONDOVI
Practice Address - State:WI
Practice Address - Zip Code:54755-2611
Practice Address - Country:US
Practice Address - Phone:715-926-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4908-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant