Provider Demographics
NPI:1366812182
Name:SCHULTZ, JANET (CPNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11828 CHAPEL ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1168
Mailing Address - Country:US
Mailing Address - Phone:410-531-6476
Mailing Address - Fax:
Practice Address - Street 1:11828 CHAPEL ESTATES DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1168
Practice Address - Country:US
Practice Address - Phone:410-531-6476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR125082363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR125082OtherBON