Provider Demographics
NPI:1316907546
Name:SCHULTZ, ANNE M (PA-C)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:SCHULTZ
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:200 THEDA CLARK MEDICAL PLZ
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-2721
Mailing Address - Country:US
Mailing Address - Phone:920-722-7747
Mailing Address - Fax:920-722-7863
Practice Address - Street 1:200 THEDA CLARK MEDICAL PLZ
Practice Address - Street 2:SUITE 310
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2721
Practice Address - Country:US
Practice Address - Phone:920-722-7747
Practice Address - Fax:920-722-7863
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI1635-023363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41982200Medicaid
WIQ00289Medicare UPIN