Provider Demographics
NPI:1457418246
Name:SCHULTZ, LAURA R (CNM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:SCHULTZ
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 GUILFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1245
Mailing Address - Country:US
Mailing Address - Phone:910-341-7213
Mailing Address - Fax:910-251-8824
Practice Address - Street 1:925 N 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3450
Practice Address - Country:US
Practice Address - Phone:910-343-0270
Practice Address - Fax:910-251-1540
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC187738367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1457418246Medicaid
NC2592109Medicare PIN