Provider Demographics
NPI:1144220070
Name:SCHULTZ, KELLI LYNN (NP)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:LYNN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N BLUFF BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7160
Mailing Address - Country:US
Mailing Address - Phone:563-243-0100
Mailing Address - Fax:563-243-0550
Practice Address - Street 1:240 N BLUFF BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7160
Practice Address - Country:US
Practice Address - Phone:563-243-0100
Practice Address - Fax:563-243-0550
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-088179363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily