Healthcare Provider Details

I. General information

NPI: 1538451703
Provider Name (Legal Business Name): NICOLE SCHULTZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE RITSI BSN

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 N HARBOR CITY BLVD
MELBOURNE FL
32935-6568
US

IV. Provider business mailing address

1565 N HARBOR CITY BLVD
MELBOURNE FL
32935-6568
US

V. Phone/Fax

Practice location:
  • Phone: 321-638-6818
  • Fax: 321-616-8126
Mailing address:
  • Phone: 321-638-6818
  • Fax: 321-616-8126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP011422
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9298519
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number621101
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: