Provider Demographics
NPI:1205482775
Name:SCHARTZ, MICHAELLA (FNP-C)
Entity type:Individual
Prefix:
First Name:MICHAELLA
Middle Name:
Last Name:SCHARTZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-4006
Mailing Address - Country:US
Mailing Address - Phone:816-651-8538
Mailing Address - Fax:
Practice Address - Street 1:3351 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-4006
Practice Address - Country:US
Practice Address - Phone:816-966-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019040280363LF0000X
KS14-136773-091163W00000X
MO2016022060163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse