Provider Demographics
NPI:1447766407
Name:SCHULZE, DAVID WAYNE II (NP-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:SCHULZE
Suffix:II
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 RENAISSANCE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3084
Mailing Address - Country:US
Mailing Address - Phone:405-844-4978
Mailing Address - Fax:
Practice Address - Street 1:1701 RENAISSANCE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3084
Practice Address - Country:US
Practice Address - Phone:405-844-4978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK102504363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily