Healthcare Provider Details

I. General information

NPI: 1073236253
Provider Name (Legal Business Name): STEPHANIE LYNN SCHULTZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N HIGH ST
LANSING MI
48906-4597
US

IV. Provider business mailing address

1717 N HIGH ST
LANSING MI
48906-4597
US

V. Phone/Fax

Practice location:
  • Phone: 517-253-8243
  • Fax: 517-371-4245
Mailing address:
  • Phone: 517-371-1700
  • Fax: 517-371-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704322266
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: