Provider Demographics
NPI:1881309136
Name:SCHULTZ, DAWN DENISE
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:DENISE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SHULT DR.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934
Mailing Address - Country:US
Mailing Address - Phone:979-493-7592
Mailing Address - Fax:
Practice Address - Street 1:107 SHULT DR.
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934
Practice Address - Country:US
Practice Address - Phone:979-493-7592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01OtherTEXAS
NONEOtherNONE