Provider Demographics
NPI:1104272608
Name:SCHULZ, REBECCA (CPM)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20385 W 51ST ST S
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-4790
Mailing Address - Country:US
Mailing Address - Phone:918-513-1100
Mailing Address - Fax:918-248-1135
Practice Address - Street 1:20361 W 51ST STREET
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063
Practice Address - Country:US
Practice Address - Phone:918-513-1100
Practice Address - Fax:918-248-1135
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CPM # 16040016176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife