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Individual
STACY SHULTZ
Active
Individual
STACY SHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28169780A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007710A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028901
—
IN
Enumeration date
12/26/2017
Last updated
11/27/2023
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