Basic Information
| Provider Information | |||||||||
| NPI: | 1265841845 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHWERING | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | EUGENE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2351 25TH ST UNIT B | ||||||||
| Address2: | |||||||||
| City: | ALAMOGORDO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 883108722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5754465303 | ||||||||
| FaxNumber: | 5754465309 | ||||||||
| Practice Location | |||||||||
| Address1: | 2351 25TH ST UNIT B | ||||||||
| Address2: | |||||||||
| City: | ALAMOGORDO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 883108722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5754465303 | ||||||||
| FaxNumber: | 5754465309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2014 | ||||||||
| LastUpdateDate: | 04/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | CNP-67544 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 1265841845 | 05 | IA | MEDICAID |