Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 209009967 | IL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209010017 | IL |
NPI | 1518201219 |
---|---|
Provider Name | Mr. Jeffrey W Schultz |
First Address | Philadelphia, PA 19101-3833 |
Second Address | Gainesville, FL 32610-0371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2012 |
Last Update Date | 03/02/2022 |