Provider Demographics
NPI:1427487685
Name:SCHULTZ, MICHELE LEANN (FNP-BC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:FNP-BC
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 527
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:IA
Mailing Address - Zip Code:52211-0527
Mailing Address - Country:US
Mailing Address - Phone:641-522-7221
Mailing Address - Fax:641-522-5816
Practice Address - Street 1:128 JACKSON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:IA
Practice Address - Zip Code:52211-7711
Practice Address - Country:US
Practice Address - Phone:641-522-7221
Practice Address - Fax:641-522-5816
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA107708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily