Provider Demographics
NPI:1972245082
Name:SCHULTZ, KERSTIN ANN
Entity Type:Individual
Prefix:
First Name:KERSTIN
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2663
Mailing Address - Country:US
Mailing Address - Phone:330-554-0938
Mailing Address - Fax:
Practice Address - Street 1:641 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2663
Practice Address - Country:US
Practice Address - Phone:330-554-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver