Provider Demographics
NPI:1427341320
Name:SCHWARTZ, DOREEN SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:SUE
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19489 S 190TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6899
Mailing Address - Country:US
Mailing Address - Phone:480-279-6655
Mailing Address - Fax:
Practice Address - Street 1:2935 S RECKER RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-7846
Practice Address - Country:US
Practice Address - Phone:480-279-7104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN137133163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool