Basic Information
| Provider Information | |||||||||
| NPI: | 1164087466 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHULTE | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4490 FREMONT PIKE | ||||||||
| Address2: | |||||||||
| City: | PERRYSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435519260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192664274 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1110 WEST MAIN CROSS ST. | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458402423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194235492 | ||||||||
| FaxNumber: | 4194243424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2019 | ||||||||
| LastUpdateDate: | 05/02/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 50.005940RX | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 11611635 | 01 | NCCPA | OTHER | 50.005940RX | 01 | OH | STATE MEDICAL BOARD OF OHIO | OTHER |