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General NPI Number Information
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NPI Number | 1073254447
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Entity Type | Individual
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Provider Name | KATHERYN NICOLE SCHULTZ
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Gender | Female
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 2298 LONGSTREET RD A
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City | FORT BRAGG
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State | NC
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Zip | 28310-7541
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Country | US
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Telephone | 910-396-2792
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Fax |
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Provider Business Mailing Address
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Address Line | 250 MARSH HAVEN DR
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City | SNEADS FERRY
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State | NC
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Zip | 28460-7541
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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