Provider Demographics
NPI:1356445597
Name:SCHUTTER, STEPHANIE MICHELLE (FNP)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:SCHUTTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9896 SOUNDING SHORE LN
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-2589
Mailing Address - Country:US
Mailing Address - Phone:703-396-7838
Mailing Address - Fax:
Practice Address - Street 1:4500 POND WAY
Practice Address - Street 2:SUITE 170
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5581
Practice Address - Country:US
Practice Address - Phone:571-542-4950
Practice Address - Fax:571-285-1160
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP99944Medicare UPIN