Healthcare Provider Details

I. General information

NPI: 1629572649
Provider Name (Legal Business Name): MICHELLE LYNN SCHULTZ NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 E LOCUST STREET HEARTLAND CARE PARTNERS
DAVENPORT IA
52803-4345
US

IV. Provider business mailing address

333 N SUMMIT STREET ; 7TH FLOOR HEARTLAND CARE PARTNERS
TOLEDO OH
43604-2615
US

V. Phone/Fax

Practice location:
  • Phone: 800-427-1902
  • Fax: 419-531-2664
Mailing address:
  • Phone: 419-252-6018
  • Fax: 800-564-5952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA111366
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209017321
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: