Provider Demographics
NPI:1639695026
Name:SCHULOF, CAROLINE A (NP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:A
Last Name:SCHULOF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 NE 125TH ST STE 409
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5834
Mailing Address - Country:US
Mailing Address - Phone:888-852-6672
Mailing Address - Fax:786-235-6225
Practice Address - Street 1:1615 FOXTRAIL DR STE 230
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9087
Practice Address - Country:US
Practice Address - Phone:970-820-0470
Practice Address - Fax:970-315-0030
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN1617810163WP0808X
COAPN.0993518363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000154888Medicaid