Provider Demographics
NPI:1326683418
Name:SCHULTZ, NICOLE LYNN (NICOLE SCHULTZ, OTR)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:NICOLE SCHULTZ, OTR
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:LYNN
Other - Last Name:WEYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NICOLE WEYER, OTR
Mailing Address - Street 1:5467 TURFWAY CIR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-2094
Mailing Address - Country:US
Mailing Address - Phone:812-630-0387
Mailing Address - Fax:
Practice Address - Street 1:8810 COLBY BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1399
Practice Address - Country:US
Practice Address - Phone:317-552-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist