Provider Demographics
NPI:1194987099
Name:SCHWARTZ, STACY B (CPNP)
Entity type:Individual
Prefix:MS
First Name:STACY
Middle Name:B
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HAMILL RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1806
Mailing Address - Country:US
Mailing Address - Phone:410-323-1144
Mailing Address - Fax:410-323-6161
Practice Address - Street 1:2 HAMILL RD
Practice Address - Street 2:SUITE 405
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1806
Practice Address - Country:US
Practice Address - Phone:410-323-1144
Practice Address - Fax:410-323-6161
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR096816363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics