Provider Demographics
NPI:1942776646
Name:KELLY SCHULTZ, LLC.
Entity Type:Organization
Organization Name:KELLY SCHULTZ, LLC.
Other - Org Name:NURSE PRACTITIONER CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, RN, AGNP-C
Authorized Official - Phone:480-883-3647
Mailing Address - Street 1:4022 E GREENWAY ROAD
Mailing Address - Street 2:SUITE 11-180
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5245
Mailing Address - Country:US
Mailing Address - Phone:866-263-3820
Mailing Address - Fax:866-857-9967
Practice Address - Street 1:4555 E MAYO BLVD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-6952
Practice Address - Country:US
Practice Address - Phone:602-883-3647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-19
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center