Healthcare Provider Details

I. General information

NPI: 1396484135
Provider Name (Legal Business Name): RACHAEL A SCHULTZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 12/23/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7860 BURR ST
SCHERERVILLE IN
46375-3402
US

IV. Provider business mailing address

127 SPRINGWOOD DR
HEBRON IN
46341-7214
US

V. Phone/Fax

Practice location:
  • Phone: 219-322-7143
  • Fax:
Mailing address:
  • Phone: 219-628-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number71012689A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: