Provider Demographics
NPI:1922735646
Name:SCHULTZ, SABRINA E (APRN)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:E
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:E
Other - Last Name:LANDGREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 776879
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6879
Mailing Address - Country:US
Mailing Address - Phone:025-559-9378
Mailing Address - Fax:502-527-2053
Practice Address - Street 1:411 E CHESTNUT ST # 5A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1713
Practice Address - Country:US
Practice Address - Phone:502-588-7450
Practice Address - Fax:502-588-7728
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018146363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK415350OtherKY MEDICARE
KY7100848480Medicaid
IN300067417Medicaid