Provider Demographics
NPI:1396273090
Name:SCHUTT, ALEXANDRA D (DNP, CPNP-PC, ARNP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:D
Last Name:SCHUTT
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, ARNP
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:D
Other - Last Name:CIAROCHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4109 INGLESIDE LOOP SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-2107
Mailing Address - Country:US
Mailing Address - Phone:253-973-0232
Mailing Address - Fax:
Practice Address - Street 1:3023 PACIFIC AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2042
Practice Address - Country:US
Practice Address - Phone:360-528-4220
Practice Address - Fax:360-528-4226
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60747582363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics