Provider Demographics
NPI:1568782423
Name:SCHULTZ, ANN MARGARET (RDLN)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARGARET
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:RDLN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29249 437TH AVE
Mailing Address - Street 2:
Mailing Address - City:MENNO
Mailing Address - State:SD
Mailing Address - Zip Code:57045-5106
Mailing Address - Country:US
Mailing Address - Phone:605-387-5713
Mailing Address - Fax:
Practice Address - Street 1:29249 437TH AVE
Practice Address - Street 2:
Practice Address - City:MENNO
Practice Address - State:SD
Practice Address - Zip Code:57045-5106
Practice Address - Country:US
Practice Address - Phone:605-387-5713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0191133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered