Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 53-75417 | KS |
NPI | 1053608661 |
---|---|
Provider Name | Shannon L Schwartz |
First Address | Topeka, KS 66606-1515 |
Second Address | Topeka, KS 66614-5614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2011 |
Last Update Date | 21/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200732360A | (05) | KS |