Healthcare Provider Details

I. General information

NPI: 1629852645
Provider Name (Legal Business Name): LAUREN NICOLE SCHULTZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 N COVE BLVD
TOLEDO OH
43606-3895
US

IV. Provider business mailing address

3019 BENDIGO LN
LAMBERTVILLE MI
48144-8696
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-4015
  • Fax:
Mailing address:
  • Phone: 419-708-8543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008350RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: