Healthcare Provider Details

I. General information

NPI: 1093922148
Provider Name (Legal Business Name): CYNTHIA TERESE SCHULTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3933 E. RIO VIRGIN RD
LITTLEFIELD AZ
86432
US

IV. Provider business mailing address

3933 E. RIO VIRGIN RD PO BOX 1085
LITTLEFIELD AZ
86432
US

V. Phone/Fax

Practice location:
  • Phone: 928-347-6064
  • Fax:
Mailing address:
  • Phone: 928-347-6064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN145587
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: