Healthcare Provider Details

I. General information

NPI: 1518201219
Provider Name (Legal Business Name): JEFFREY W SCHULTZ MS, APRN, ACNP, CCNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-0371
US

IV. Provider business mailing address

PO BOX 13833
PHILADELPHIA PA
19101-3833
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-7922
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number041314111
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041314111
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number209010017
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number209010017
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code364SE0003X
TaxonomyEmergency Clinical Nurse Specialist
License Number209010017
License Number StateIL
# 7
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209009967
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: