Provider Demographics
NPI:1770530180
Name:SCHOOK, JENNIFER LYN (PA-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYN
Last Name:SCHOOK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:LYN
Other - Last Name:MESSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2830 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-7115
Mailing Address - Country:US
Mailing Address - Phone:941-927-1234
Mailing Address - Fax:941-921-0043
Practice Address - Street 1:2830 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7115
Practice Address - Country:US
Practice Address - Phone:941-927-1234
Practice Address - Fax:941-921-0043
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104673363AM0700X
VA0110001942363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010206944Medicaid
VA010206910Medicaid
VA010206863Medicaid
Q30357Medicare UPIN
VA010206944Medicaid