Provider Demographics
NPI:1538425269
Name:SCHWENTKER, AMY LYNN (RNFA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:SCHWENTKER
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FOREST BROOK CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1988
Mailing Address - Country:US
Mailing Address - Phone:636-578-6301
Mailing Address - Fax:
Practice Address - Street 1:539 DEER BROOK DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-5051
Practice Address - Country:US
Practice Address - Phone:636-578-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007019869163WR0006X
MO2021011348363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant