Provider Demographics
NPI:1972072825
Name:SCHULTZ, SARAH JEAN (CNM)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3976 UNIVERSITY LAKE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4644
Mailing Address - Country:US
Mailing Address - Phone:907-222-9930
Mailing Address - Fax:907-222-9931
Practice Address - Street 1:3976 UNIVERSITY LAKE DR STE 300
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4644
Practice Address - Country:US
Practice Address - Phone:907-222-9930
Practice Address - Fax:907-222-9931
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704308269367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704308269OtherSTATE LICENSE