Basic Information
| Provider Information | |||||||||
| NPI: | 1144467556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHULTZ | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | JOAN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PMHNP-BC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MESTACH | ||||||||
| OtherFirstName: | BARBARA | ||||||||
| OtherMiddleName: | JOAN | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PMHNP-BC | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 25 N SPRUCE ST | ||||||||
| Address2: | RM 210 J | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809051436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196674428 | ||||||||
| FaxNumber: | 7196338741 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 N SPRUCE ST | ||||||||
| Address2: | RM 210 J | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809051436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196674428 | ||||||||
| FaxNumber: | 7196338741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2009 | ||||||||
| LastUpdateDate: | 08/06/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 592795 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.