Provider Demographics
NPI:1013447168
Name:SCHUTTE, ANGELA K (RXN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:K
Last Name:SCHUTTE
Suffix:
Gender:F
Credentials:RXN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:K
Other - Last Name:MCCRACKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8231 BROOKCREST DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5272
Mailing Address - Country:US
Mailing Address - Phone:517-936-8679
Mailing Address - Fax:
Practice Address - Street 1:675 WAGNER DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017
Practice Address - Country:US
Practice Address - Phone:269-969-6244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORXN.0103213-NP363LP0808X
MI4704356235363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health