Doctor Name: | BETHANY K SCHULTZ |
NPI Number: | 1013263979 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | CNP4220 |
Business Practice Address: | 112 Saint Olaf Ave S Canby, MN - 562201433 |
Business Phone Number: | 5072237277 |
Business Fax Number: | 5072237886 |
Mailing Address: | 112 Saint Olaf Ave S, CANBY |
State: | MN |
Postal Code: | 562201433 |
Phone Number: | 5072237277 |
Fax Number: | 5072237886 |
NPI Enumeration Date: | 07/30/2012 |
NPI Last Update Date: | 11/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP4220 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |