Provider Demographics
NPI:1841579828
Name:SCHULTZ, CLARA ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:ELIZABETH
Last Name:SCHULTZ
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 1:2845 US HIGHWAY 2/41
Mailing Address - Street 2:
Mailing Address - City:BARK RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49807-9661
Mailing Address - Country:US
Mailing Address - Phone:906-466-2000
Mailing Address - Fax:906-466-2067
Practice Address - Street 1:2845 US HIGHWAY 2/41
Practice Address - Street 2:
Practice Address - City:BARK RIVER
Practice Address - State:MI
Practice Address - Zip Code:49807-9661
Practice Address - Country:US
Practice Address - Phone:906-466-2000
Practice Address - Fax:906-466-2067
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704210947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704210947OtherLICENSE NUMBER