Healthcare Provider Details

I. General information

NPI: 1639101959
Provider Name (Legal Business Name): KRISTY L. SCHUH APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N 9TH ST STE 656
BISMARCK ND
58501-4530
US

IV. Provider business mailing address

401 N 9TH ST STE 656
BISMARCK ND
58501-4530
US

V. Phone/Fax

Practice location:
  • Phone: 701-712-4500
  • Fax: 214-820-3468
Mailing address:
  • Phone: 701-712-4500
  • Fax: 214-820-3468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number721191
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP114469
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR28269
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: