Individual
JEFFERY R. SCHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
202 PROSPECT DR, GLENDIVE, MT 59330-1943
(406) 345-3345
(406) 345-3347
Mailing address
202 PROSPECT DR, GLENDIVE, MT 59330-1943
(406) 345-3345
(406) 345-3347
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ANT9242362
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0025769 00
—
FL
01
—
1255650610
CHAMPUS (TRICARE - SOUTH REGION)
—
01
—
G00FP
BCBS
FL
Enumeration date
05/25/2010
Last updated
07/09/2015
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