Provider Demographics
NPI:1912724451
Name:SCHULTZ, LAYNA VICTORIA (WHNP)
Entity type:Individual
Prefix:MS
First Name:LAYNA
Middle Name:VICTORIA
Last Name:SCHULTZ
Suffix:
Gender:
Credentials:WHNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412065
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2065
Mailing Address - Country:US
Mailing Address - Phone:314-432-3669
Mailing Address - Fax:314-432-3118
Practice Address - Street 1:3023 N BALLAS RD
Practice Address - Street 2:STE 120D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2330
Practice Address - Country:US
Practice Address - Phone:314-432-3669
Practice Address - Fax:314-432-3118
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2024043357363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420149590Medicaid