Provider Demographics
NPI:1578547816
Name:SCHULZKUMP, LINDA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SCHULZKUMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:805 WEST 10TH STREET
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-0185
Mailing Address - Country:US
Mailing Address - Phone:402-443-4191
Mailing Address - Fax:402-443-1401
Practice Address - Street 1:805 W 10TH ST
Practice Address - Street 2:
Practice Address - City:WAHOO
Practice Address - State:NE
Practice Address - Zip Code:68066-1102
Practice Address - Country:US
Practice Address - Phone:402-443-4191
Practice Address - Fax:402-443-1401
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE21980207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE237125OtherMIDLANDS CHOICE
NE30592OtherBLUE CROSS BLUE SHIELD
NE30592OtherBLUE CROSS BLUE SHIELD
NE237125OtherMIDLANDS CHOICE