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General NPI Number Information
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NPI Number | 1437895281
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Entity Type | Individual
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Provider Name | ANDY LEE SCHULTZ
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Gender | Male
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 1877 WILLIAMS HWY
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City | GRANTS PASS
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State | OR
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Zip | 97527-5802
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Country | US
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Telephone | 541-955-5551
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Fax | 541-955-7171
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Provider Business Mailing Address
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Address Line | 1877 WILLIAMS HWY
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City | GRANTS PASS
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State | OR
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Zip | 97527-5802
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Country | US
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Telephone | 541-955-5551
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Fax | 541-955-7171
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 201143201RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 201143201RN
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License Number State | OR
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