MEDICARE: MS. SUSAN ANNE SCHMALTZ APRN, AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	10363	AZ
2	363LA2100X	Acute Care Nurse Practitioner	AP10363	AZ

General Provider Information

NPI Number	:	1063930147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN ANNE SCHMALTZ APRN, AGACNP-BC

Provider Business Mailing Address
First Line	:	222 LAKEVIEW AVE STE 735
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-6145
Country	:	US
Telephone Number	:	231-432-5841
Fax Number	:

Provider Business Practice Location Address
First Line	:	1952 W PASO TRI
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085
Country	:	US
Telephone Number	:	231-432-5841
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	04/03/2026

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