Basic Information
Provider Information
NPI: 1184677916
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWARTZ
FirstName: JASON
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MS, APRN,BC
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 24 FRANK LLOYD WRIGHT DR
Address2: PO BOX 0446 LOBBY J
City: ANN ARBOR
State: MI
PostalCode: 481059484
CountryCode: US
TelephoneNumber: 7347476766
FaxNumber: 7342223100
Practice Location
Address1: 5333 MCAULEY DR
Address2: SUITE 6109
City: YPSILANTI
State: MI
PostalCode: 481971014
CountryCode: US
TelephoneNumber: 7347121400
FaxNumber: 7347121670
Other Information
ProviderEnumerationDate: 05/19/2006
LastUpdateDate: 04/04/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X4704230059MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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