1598968984 NPI number — MRS. DONNA RUTH SCHWARTZ APRN MSN

Table of content: MRS. DONNA RUTH SCHWARTZ APRN MSN (NPI 1598968984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598968984 NPI number — MRS. DONNA RUTH SCHWARTZ APRN MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZ
Provider First Name:
DONNA
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TREGRE
Provider Other First Name:
DONNA
Provider Other Middle Name:
RUTH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN MSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598968984
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
119 HERITAGE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKFORT
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40601-7639
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-352-6698
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 WEST LOUDON AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-252-7881
Provider Business Practice Location Address Fax Number:
859-255-0749
Provider Enumeration Date:
06/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  5048P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100045870 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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