MEDICARE: RICHARD WARREN SCHULZ

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024171247	VA

General Provider Information

NPI Number	:	1447670005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD WARREN SCHULZ

Provider Business Mailing Address
First Line	:	6045 BRADFORD DR APT B
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23435-2934
Country	:	US
Telephone Number	:	571-296-1141
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 SENTARA WAY
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-4200
Country	:	US
Telephone Number	:	571-296-1141
Fax Number	:

Authorized Official
Title or Position	:	PSYCHIATRIC NURSE PRACTITIONER
Name	:	RICHARD WARREN SCHULZ
Credential	:	PMHNP-BC
Telephone Number	:	571-296-1141

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	04/22/2014

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