Provider Demographics
NPI:1659646438
Name:SCHULTZ, PEGGY A (RN)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:A
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 1:151 W 7TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2676
Mailing Address - Country:US
Mailing Address - Phone:541-682-8779
Mailing Address - Fax:541-682-6703
Practice Address - Street 1:151 W 7TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2676
Practice Address - Country:US
Practice Address - Phone:541-682-8779
Practice Address - Fax:541-682-6703
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR087003104RN163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator