Provider Demographics
NPI:1699079343
Name:SCHUTTEN, SCOTT J (NP)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:SCHUTTEN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 FORREST DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-4577
Mailing Address - Country:US
Mailing Address - Phone:262-514-3851
Mailing Address - Fax:
Practice Address - Street 1:818 FORREST DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:WI
Practice Address - Zip Code:53185-4577
Practice Address - Country:US
Practice Address - Phone:262-514-3851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4315363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner