MEDICARE: CELESTE M SCHULTZ RNC MS CPNP

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	363LP0200X	Pediatric Nurse Practitioner	RN149235	OH
2	363LP0200X	Pediatric Nurse Practitioner	NP00066	OH
3	363LP0200X	Pediatric Nurse Practitioner	CTP00066RX	OH
4	363LP0200X	Pediatric Nurse Practitioner	4704139413	MI
5	363LP0200X	Pediatric Nurse Practitioner	1493086	MI
6	363LP0200X	Pediatric Nurse Practitioner	1492748	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619962826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTE M SCHULTZ RNC MS CPNP

Provider Business Mailing Address
First Line	:	4235 SECOR RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4231
Country	:	US
Telephone Number	:	419-473-3561
Fax Number	:

Provider Business Practice Location Address
First Line	:	3949 SUNFOREST CT
Second Line	:	STE 203 TWIN OAKS PEDIATRICS
City	:	TOLEDO
State	:	OH
Zip	:	43623-4473
Country	:	US
Telephone Number	:	419-292-0191
Fax Number	:	419-292-0589

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/31/2012

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