Provider Demographics
NPI:1649697053
Name:JEANANN SCHWARK, MS, FNP-C, PLLC
Entity type:Organization
Organization Name:JEANANN SCHWARK, MS, FNP-C, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, FNP-C
Authorized Official - Phone:480-825-7941
Mailing Address - Street 1:10615 N HAYDEN RD # C-100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5734
Mailing Address - Country:US
Mailing Address - Phone:480-825-7941
Mailing Address - Fax:480-825-7945
Practice Address - Street 1:10615 N HAYDEN RD # C-100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5734
Practice Address - Country:US
Practice Address - Phone:480-825-7941
Practice Address - Fax:480-825-7945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN 049446 AP1637363LF0000X, 363LX0001X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ836471Medicaid
AZ1659372472OtherINDIVIDUAL PROVIDER NPI
AZ1659372472OtherINDIVIDUAL PROVIDER NPI