Provider Demographics
NPI:1477618684
Name:SCHULTZ, MARY ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5143 0LD TAYLOR MILL RD.
Mailing Address - Street 2:
Mailing Address - City:TAYLOR MILL
Mailing Address - State:KY
Mailing Address - Zip Code:41015-4103
Mailing Address - Country:US
Mailing Address - Phone:859-240-9708
Mailing Address - Fax:859-261-0623
Practice Address - Street 1:5143 OLD TAYLOR MILL RD
Practice Address - Street 2:
Practice Address - City:TAYLOR MILL
Practice Address - State:KY
Practice Address - Zip Code:41015-4103
Practice Address - Country:US
Practice Address - Phone:859-240-9708
Practice Address - Fax:859-261-0623
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1042613163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1628OtherFIRST STEPS