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NPI Code Detail

MEDICARE: MRS. TARA L. SCHULTZ APRN

MEDICARE: MRS. TARA L. SCHULTZ APRN
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
1363LF0000XFamily Nurse Practitioner74108OK

General Provider Information

NPI Number : 1598213134
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TARA L. SCHULTZ APRN
Provider Business Mailing Address
First Line : 5300 N INDEPENDENCE AVE STE 280
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-5555
Country : US
Telephone Number : 405-357-3500
Fax Number : 405-357-3519
Provider Business Practice Location Address
First Line : 7301 SW 44TH ST STE A
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73179-4309
Country : US
Telephone Number : 405-357-3500
Fax Number : 405-357-3519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2016
Last Update Date : 11/19/2019

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