Provider Demographics
NPI:1023068442
Name:SCHULZ, CHARLENE JOAN (MS, DRPH)
Entity type:Individual
Prefix:PROF
First Name:CHARLENE
Middle Name:JOAN
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:MS, DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S YELLOWSTONE DR APT 108
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4354
Mailing Address - Country:US
Mailing Address - Phone:917-951-8028
Mailing Address - Fax:
Practice Address - Street 1:4621 EASTPARK BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-2000
Practice Address - Country:US
Practice Address - Phone:608-504-4286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY93134170300000X
WI1074-61170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS