Healthcare Provider Details

I. General information

NPI: 1124840053
Provider Name (Legal Business Name): DENNIS SCHUT DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CREST RD
SAINT ALBANS VT
05478-9753
US

IV. Provider business mailing address

3 CREST RD
SAINT ALBANS VT
05478-9753
US

V. Phone/Fax

Practice location:
  • Phone: 802-524-4554
  • Fax:
Mailing address:
  • Phone: 802-524-4554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number101.0137354
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: