Provider Demographics
NPI:1538392600
Name:SHULTZ, BELINDA ANN (NP)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:ANN
Last Name:SHULTZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BELINDA
Other - Middle Name:SHULTZ
Other - Last Name:DANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3943 OLD JACKSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8519
Mailing Address - Country:US
Mailing Address - Phone:035-931-2129
Mailing Address - Fax:
Practice Address - Street 1:3943 OLD JACKSONVIL RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8519
Practice Address - Country:US
Practice Address - Phone:903-593-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX741876363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner