Healthcare Provider Details

I. General information

NPI: 1710260518
Provider Name (Legal Business Name): KARLA A SCHULTZ CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 MARION AVE NW
MASSILLON OH
44646-3639
US

IV. Provider business mailing address

323 MARION AVE NW
MASSILLON OH
44646-3639
US

V. Phone/Fax

Practice location:
  • Phone: 330-837-6114
  • Fax: 330-837-6118
Mailing address:
  • Phone: 330-837-6114
  • Fax: 330-837-6118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA12708NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: