Provider Demographics
NPI:1336849520
Name:SCHULTZ-HEINZ, CONSTANCE
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:SCHULTZ-HEINZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAMERON
Other - Middle Name:
Other - Last Name:HEINZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1810 MAPLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-4801
Mailing Address - Country:US
Mailing Address - Phone:765-810-5045
Mailing Address - Fax:
Practice Address - Street 1:1810 MAPLEWOOD CT
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064-4801
Practice Address - Country:US
Practice Address - Phone:765-810-5045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider