Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 4704356235 | MI |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RXN.0103213-NP | CO |
NPI | 1013447168 |
---|---|
Provider Name | Angela K Schutte |
First Address | Portage, MI 49024-5272 |
Second Address | Battle Creek, MI 49017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2017 |
Last Update Date | 11/09/2019 |