Individual
KELLY M SCHULZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
171W00000X
Contractor
—
—
174400000X
Specialist
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
305S00000X
Point of Service
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47399000443221A002
TRICARE
—
Enumeration date
10/22/2019
Last updated
10/22/2019
Update your record
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