Healthcare Provider Details

I. General information

NPI: 1063909364
Provider Name (Legal Business Name): KELLY ALEXANDRA SCHOCH DNP, APN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY ALEXANDRA HUGHES BSN, RN

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 LARK DR
ALBANY NY
12207-1300
US

IV. Provider business mailing address

920 LARK DR
ALBANY NY
12207-1300
US

V. Phone/Fax

Practice location:
  • Phone: 518-465-4771
  • Fax:
Mailing address:
  • Phone: 518-465-4771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number831113
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR17897000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ00816700
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF421544-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: