Provider Demographics
NPI:1386342103
Name:SCHUTZ, JILL (RN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:SCHUTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 10TH ST N
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:50459-1041
Mailing Address - Country:US
Mailing Address - Phone:641-390-0744
Mailing Address - Fax:
Practice Address - Street 1:320 N EISENHOWER AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-1521
Practice Address - Country:US
Practice Address - Phone:641-548-6195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA127109163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse