Individual
PENNY JO SCHULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3791
Mailing address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3791
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4348-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115450-030
RESISTERED NURSE
WI
01
—
4348-33
ADVANCED PRACTICE NURSE PRESCRIBER LICENSE
WI
Enumeration date
02/16/2011
Last updated
02/16/2011
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