Provider Demographics
NPI:1700300233
Name:SCHULTZ, VICTORIA ANN (ANP, PMHNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:ANP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 PATROON POINTE DR
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-8438
Mailing Address - Country:US
Mailing Address - Phone:631-766-2902
Mailing Address - Fax:
Practice Address - Street 1:391 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1401
Practice Address - Country:US
Practice Address - Phone:518-242-4731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305221363LA2200X
NYF402192363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health