Provider Demographics
NPI:1861691537
Name:SCHULTZ, BECKY BEA (LPN)
Entity type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:BEA
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:BECKY
Other - Middle Name:BEA
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:29853 90TH AVE N
Mailing Address - Street 2:
Mailing Address - City:HITTERDAL
Mailing Address - State:MN
Mailing Address - Zip Code:56552
Mailing Address - Country:US
Mailing Address - Phone:218-962-3244
Mailing Address - Fax:
Practice Address - Street 1:160 4TH AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1734
Practice Address - Country:US
Practice Address - Phone:218-998-3778
Practice Address - Fax:218-998-3187
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL0565257164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse