Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | A063970 | IA |
NPI | 1003083718 |
---|---|
Provider Name | Janette M Schulz |
First Address | West Burlington, IA 52655-1682 |
Second Address | West Burlington, IA 52655-1682 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 12/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003083718 | (05) | IA |
1003083718 | WELLMARK (01) | IA |
P00876854 | RAILROAD MEDICARE (01) | IA |