Provider Demographics
NPI:1558879106
Name:SCHULTZ, ASHLEY NICKOLE (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICKOLE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 E FORT LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3920
Mailing Address - Country:US
Mailing Address - Phone:602-589-0550
Mailing Address - Fax:
Practice Address - Street 1:5355 E ERICKSON DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2826
Practice Address - Country:US
Practice Address - Phone:520-299-8200
Practice Address - Fax:520-299-8202
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10907363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ353588Medicaid