| Doctor Name: | NICHOLE M SHULTZ |
| NPI Number: | 1033419825 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 71003388A |
| Business Practice Address: | 601 W. Kieffer Road Michigan City, IN - 463609599 |
| Business Phone Number: | 2198796262 |
| Business Fax Number: | 2198741885 |
| Mailing Address: | 1100 Lincolnway, LA PORTE |
| State: | IN |
| Postal Code: | 463503289 |
| Phone Number: | 2193262489 |
| Fax Number: | 2193262418 |
| NPI Enumeration Date: | 10/26/2010 |
| NPI Last Update Date: | 10/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 71003388A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |