Basic Information
Provider Information
NPI: 1356784474
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWERING
FirstName: TESSA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BLACK
OtherFirstName: TESSA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 1200 MOUNTAIN ST STE 230
Address2:  
City: CARSON CITY
State: NV
PostalCode: 897033867
CountryCode: US
TelephoneNumber: 7758821324
FaxNumber: 7758829714
Practice Location
Address1: 1475 MEDICAL PKWY
Address2:  
City: CARSON CITY
State: NV
PostalCode: 897034635
CountryCode: US
TelephoneNumber: 7758833636
FaxNumber: 7758822382
Other Information
ProviderEnumerationDate: 04/08/2013
LastUpdateDate: 10/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMD2017-0743NMN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X20225NVY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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