Healthcare Provider Details

I. General information

NPI: 1053826354
Provider Name (Legal Business Name): NURSE PRACTITIONERS R US
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 E MAYO BLVD
PHOENIX AZ
85050
US

IV. Provider business mailing address

3944 E HILLERY DR
PHOENIX AZ
85032-5245
US

V. Phone/Fax

Practice location:
  • Phone: 602-883-3647
  • Fax:
Mailing address:
  • Phone: 602-883-3647
  • Fax: 602-795-6302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberAP7985
License Number StateAZ

VIII. Authorized Official

Name: DR. KELLY LYNN SCHULTZ
Title or Position: CO-OWNER
Credential: DNP
Phone: 602-883-3647