Provider Demographics
NPI:1063909364
Name:SCHOCH, KELLY ALEXANDRA (DNP, APN, WHNP-BC)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ALEXANDRA
Last Name:SCHOCH
Suffix:
Gender:F
Credentials:DNP, APN, WHNP-BC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ALEXANDRA
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:920 LARK DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12207-1300
Mailing Address - Country:US
Mailing Address - Phone:518-465-4771
Mailing Address - Fax:
Practice Address - Street 1:920 LARK DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-1300
Practice Address - Country:US
Practice Address - Phone:518-465-4771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY831113163W00000X
NJ26NR17897000163W00000X
NJ26NJ00816700363LW0102X
NYF421544-01363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse