Provider Demographics
NPI:1316556269
Name:SCHULTZ, BRONTE HEATH (PA-C)
Entity Type:Individual
Prefix:
First Name:BRONTE
Middle Name:HEATH
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRONTE
Other - Middle Name:HEATH
Other - Last Name:GIFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:236 15TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4254
Mailing Address - Country:US
Mailing Address - Phone:580-297-0112
Mailing Address - Fax:
Practice Address - Street 1:236 15TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4254
Practice Address - Country:US
Practice Address - Phone:580-297-0112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0845363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant