Doctor Name: | BRENDA S SCHULTY |
NPI Number: | 1275889404 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | COA.13519-NP |
Business Practice Address: | 725 S Shoop Ave Wauseon, OH - 435671702 |
Business Phone Number: | 4193302626 |
Business Fax Number: | |
Mailing Address: | 8220 Twin Creek Cir, TEMPERANCE |
State: | MI |
Postal Code: | 481828202 |
Phone Number: | 7342240733 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2012 |
NPI Last Update Date: | 01/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA.13519-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |