Provider Demographics
NPI:1073953329
Name:SHULTZ, KIMBERLY RENEE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:RENEE
Last Name:SHULTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:972-754-5317
Mailing Address - Fax:
Practice Address - Street 1:JOHNS HOPKINS HOSPITAL
Practice Address - Street 2:600 NORTH WOLFE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-5601
Practice Address - Country:US
Practice Address - Phone:972-754-5317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant