Provider Demographics
NPI:1861867202
Name:SCHWERIN, VIRGINIA MONICA (LDEM)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:MONICA
Last Name:SCHWERIN
Suffix:
Gender:F
Credentials:LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 W 100 S
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-4355
Mailing Address - Country:US
Mailing Address - Phone:801-796-2229
Mailing Address - Fax:800-714-4718
Practice Address - Street 1:489 W 100 S
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-4355
Practice Address - Country:US
Practice Address - Phone:801-796-2229
Practice Address - Fax:800-714-4718
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9603753-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife