MEDICARE: KATRICIA MARIE SCHULTZ

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1083986889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRICIA MARIE SCHULTZ

Provider Business Mailing Address
First Line	:	2231 OAK GROVE PL
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3413
Country	:	US
Telephone Number	:	419-389-2940
Fax Number	:

Provider Business Practice Location Address
First Line	:	2231 OAK GROVE PL
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-3413
Country	:	US
Telephone Number	:	419-389-2940
Fax Number	:

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

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	02/24/2012

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