Healthcare Provider Details

I. General information

NPI: 1225741580
Provider Name (Legal Business Name): ALEXIS MARIE SCHULTZ CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXIS BROWN APRN-CRNA, DNP

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 BROADWAY ST
QUINCY IL
62301-2834
US

IV. Provider business mailing address

1005 BROADWAY ST
QUINCY IL
62301-2834
US

V. Phone/Fax

Practice location:
  • Phone: 217-223-1200
  • Fax: 217-223-9552
Mailing address:
  • Phone: 217-223-8400
  • Fax: 217-277-3960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN9487604
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209027709
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: