Provider Demographics
NPI:1831200542
Name:SCHULTE, RANEEN E (PA)
Entity type:Individual
Prefix:MS
First Name:RANEEN
Middle Name:E
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9255
Mailing Address - Fax:515-875-9223
Practice Address - Street 1:5950 UNIVERSITY AVE
Practice Address - Street 2:STE 221
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-875-9115
Practice Address - Fax:515-875-9117
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001429363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA51391005Medicare PIN
IA51391005Medicare PIN
MI1058112590OtherBCBS INDIVIDUAL
MIM86720017Medicare PIN
MIM86730017Medicare PIN
MIP66442Medicare UPIN