Tiffany Leigh Schultheis, RN

Individual provider Active NPI Critical Care Medicine Registered Nurse · Fults, IL

NPI 1497072912 · NPPES record last updated Apr 23, 2010

Key facts

NPI
1497072912
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Medicine Registered Nurse 163WC0200X
License
2005008604 (MO)
Practice address
4507 Ashley LN
Fults, IL 62244-1529
Phone
(618) 458-7398
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041356623ILMDRegistered Nurse
2005008604MOMDCritical Care Medicine Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041356623 IL
Critical Care Medicine Registered Nurse 163WC0200X 2005008604 MO Yes

Addresses

Primary practice location

4507 Ashley LN
Fults, IL 62244-1529

Mailing address

4507 Ashley LN
Fults, IL 62244-1529
Phone (618) 458-7398

Other names

  • Tiffany Leigh Metz Former name

Other providers in Fults, IL

All providers in Fults, IL · Critical Care Medicine Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.