Healthcare Provider Details

I. General information

NPI: 1720512239
Provider Name (Legal Business Name): KRISTINA SCHULZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E SOUTH ST
MANLY IA
50456-5058
US

IV. Provider business mailing address

245 W O ST
FOREST CITY IA
50436-1119
US

V. Phone/Fax

Practice location:
  • Phone: 641-454-2223
  • Fax:
Mailing address:
  • Phone: 641-590-7912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number137795
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: