Provider Demographics
NPI:1437411907
Name:SCHLUETER, OCTAVIA SIEGEL-HAWLEY (NP)
Entity Type:Individual
Prefix:MRS
First Name:OCTAVIA
Middle Name:SIEGEL-HAWLEY
Last Name:SCHLUETER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:OCTAVIA
Other - Middle Name:KENDALL
Other - Last Name:SIEGEL HAWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9407 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEW KENT
Mailing Address - State:VA
Mailing Address - Zip Code:23124-2029
Mailing Address - Country:US
Mailing Address - Phone:804-966-2242
Mailing Address - Fax:
Practice Address - Street 1:9407 CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:NEW KENT
Practice Address - State:VA
Practice Address - Zip Code:23124-2029
Practice Address - Country:US
Practice Address - Phone:804-966-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017140020363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics