Provider Demographics
NPI:1275551780
Name:SCHATZ, ALICE M (PA-C)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:M
Last Name:SCHATZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:ND
Mailing Address - Zip Code:58552
Mailing Address - Country:US
Mailing Address - Phone:701-254-4531
Mailing Address - Fax:701-254-5459
Practice Address - Street 1:511 E. ELM AVE
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:ND
Practice Address - Zip Code:58552
Practice Address - Country:US
Practice Address - Phone:701-254-4531
Practice Address - Fax:701-254-5459
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0134363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDP00356537OtherRR MEDICARE
P00356537OtherRR MEDICARE
P00356537OtherRR MEDICARE
N712284Medicare PIN
NDN712284Medicare PIN