Provider Demographics
NPI:1720512239
Name:SCHULZ, KRISTINA (RN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SCHULZ
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 1:245 W O ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50436-1119
Mailing Address - Country:US
Mailing Address - Phone:641-590-7912
Mailing Address - Fax:
Practice Address - Street 1:601 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:MANLY
Practice Address - State:IA
Practice Address - Zip Code:50456-5058
Practice Address - Country:US
Practice Address - Phone:641-454-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1377953747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider