Provider Demographics
NPI:1821391640
Name:SCHWEPPE APRN,, LYNNE ANNETTE (MSN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:ANNETTE
Last Name:SCHWEPPE APRN,
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:ANNETTE
Other - Last Name:MUNDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAIDEN NAME
Mailing Address - Street 1:PO BOX 813
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-0813
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1631 S GALENA AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032
Practice Address - Country:US
Practice Address - Phone:815-391-1000
Practice Address - Fax:815-720-4950
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041291775163WC1500X
IL309003730363LP0808X
IL209.018610363LP0808X
IAG145748363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health