Provider Demographics
NPI:1265460315
Name:SCHUTT, STEPHANIE L (NP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:L
Last Name:SCHUTT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-4021
Mailing Address - Country:US
Mailing Address - Phone:615-851-5151
Mailing Address - Fax:615-851-5151
Practice Address - Street 1:436 DRY CREEK RD
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-4021
Practice Address - Country:US
Practice Address - Phone:615-851-5151
Practice Address - Fax:615-851-5151
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 8288363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3348548Medicaid
TN3348548Medicare ID - Type Unspecified
TNP91913Medicare UPIN
TN3348548Medicaid