Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AP7895 | AZ |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 823317398 | AZ |
NPI | 1023499860 |
---|---|
Provider Name | Dr. Kelly Lynn Schultz |
First Address | Phoenix, AZ 85032-5245 |
Second Address | Phoenix, AZ 85032-5245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2015 |
Last Update Date | 30/11/2017 |