MICHELLE R SHOULTZ (NPI# 1457439747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457439747 |
| Entity Type | Individual |
| Full Name | MICHELLE R SHOULTZ |
| Credential | PA-C |
| Practice Address |
545 Old Norcross Rd Ste 300 Lawrenceville GA 30045-3390 |
| Practice Telephone | 7709636300 |
| Practice Fax Number | 6782871664 |
| Mailing Telephone | 7709636300 |
| Mailing Fax Number | 6782871664 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2010-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
004938 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
004938 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GEORGIA LICENSE NUMBER | 004938 | 01 |
| Street Address |
545 OLD NORCROSS RD STE 300 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-3390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114401478 | Denise Alicia Harris | Nurse Practitioner | 545 Old Norcross Rd Ste 300, Lawrenceville, GA 30046-3390 | 2018-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811531767 | Kaceyanne Lynn Cerankowski | Physician Assistant | 3131 Princeton Pike Bldg 4a, Lawrenceville, NJ 08648-2201 | 2019-11-04 |
| 1528579950 | Julia Vlada Shumkov | Physician Assistant | 3100 Princeton Pike Ste D, Lawrenceville, NJ 08648-2300 | 2017-10-12 |
| 1851631337 | Dave George | Physician Assistant | 1960 Riverside Parkway Ste#106, Lawrenceville, GA 30043 | 2013-02-21 |
| 1528375946 | Gillian Robinson | Physician Assistant | 900 Legacy Park Dr, Apt 2333, Lawrenceville, GA 30043-8715 | 2010-09-07 |
| 1376705996 | Jacqueline Anne Ritter | Physician Assistant | 123 Franklin Corner Rd Ste 216, Lawrenceville, NJ 08648 | 2008-06-25 |
| 1326132408 | Michael Johnson | Physician Assistant | 289 Grayson Hwy Ste 2a, Lawrenceville, GA 30046-5726 | 2006-10-03 |
| 1689626657 | Nocollege A Pupuma | Physician Assistant | 1431 Riverside Pkwy, Suite B, Lawrenceville, GA 30043-5946 | 2006-05-17 |
| 1073576716 | Jennifer T. Herbstritt | Physician Assistant | 2500 Brunswick Pike, Suite 101a, Professional Healthcare Services of Lawrenceville, Lawrenceville, NJ 08648-4134 | 2006-04-11 |
| 1285260745 | Elizabeth Joy Elder Sandy | Physician Assistant | 595 Hurricane Shoals Rd Nw Ste 100, Lawrenceville, GA 30046-8762 | 2020-03-17 |
| 1972085223 | Amber Nicole Matthews | Physician Assistant | 2775 Cruse Rd, Lawrenceville, GA 30044-7140 | 2018-09-04 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
Please comment or provide details below to improve the information on MICHELLE R SHOULTZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.