Provider Demographics
NPI:1891754867
Name:SCHUTTER, AMY HOSTELLEY (CRNA)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:HOSTELLEY
Last Name:SCHUTTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:HOSTELLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-4399
Mailing Address - Fax:
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-2025
Practice Address - Country:US
Practice Address - Phone:570-271-6621
Practice Address - Fax:570-271-6762
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN309652L367500000X
MDR230694367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P14574Medicare UPIN
PA042554Medicare ID - Type Unspecified