Individual
KYLA R SHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4929 OAK ST, QUINCY, IL 62305-9133
(217) 223-8400
(217) 214-9637
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2017032885
MO
363LF0000X
Family Nurse Practitioner
Primary
209018198
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017032885
LICENSE
MO
Enumeration date
06/25/2018
Last updated
10/24/2025
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