Provider Demographics
NPI:1407881089
Name:SCHUETZ, ANDRE C (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:C
Last Name:SCHUETZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 SWAN CT
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:96022-9579
Mailing Address - Country:US
Mailing Address - Phone:530-347-9641
Mailing Address - Fax:
Practice Address - Street 1:2550 SISTER MARY COLUMBA DR
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4327
Practice Address - Country:US
Practice Address - Phone:530-529-8340
Practice Address - Fax:530-527-9517
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473043367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN4730430Medicaid
CARN4730430Medicaid
CAR21375Medicare UPIN