Provider Demographics
NPI:1073525929
Name:SCHULZ, EMILY MOLLERE (RN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MOLLERE
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:EDWIGE
Other - Last Name:MOLLERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:356 BALLENTINE ST
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-3902
Mailing Address - Country:US
Mailing Address - Phone:228-523-4304
Mailing Address - Fax:
Practice Address - Street 1:400 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-2410
Practice Address - Country:US
Practice Address - Phone:228-523-4304
Practice Address - Fax:228-523-5731
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR584169163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health