MEDICARE: HILLARY JEAN SHULTZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN00164928	WA

General Provider Information

NPI Number	:	1023590833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILLARY JEAN SHULTZ

Provider Business Mailing Address
First Line	:	18818 E MARLIN DR
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99027-9560
Country	:	US
Telephone Number	:	509-215-0473
Fax Number	:

Provider Business Practice Location Address
First Line	:	18818 E MARLIN DR
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99027-9560
Country	:	US
Telephone Number	:	509-215-0473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2018
Last Update Date	:	08/29/2018

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