Provider Demographics
NPI:1659372472
Name:SCHWARK, JEANANN (MS, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JEANANN
Middle Name:
Last Name:SCHWARK
Suffix:
Gender:F
Credentials:MS, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8070 E MORGAN TRL
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1227
Mailing Address - Country:US
Mailing Address - Phone:480-825-7941
Mailing Address - Fax:480-825-7945
Practice Address - Street 1:8070 E MORGAN TRL
Practice Address - Street 2:SUITE 120
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1227
Practice Address - Country:US
Practice Address - Phone:480-825-7941
Practice Address - Fax:480-825-7945
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1637363LF0000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ836471Medicaid
AZ836471Medicaid