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General NPI Number Information
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NPI Number | 1902172372
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Entity Type | Individual
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Provider Name | KARLA ANNE SCHUTZENHOFER APN
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Gender | Female
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 1054 MARTIN LUTHER KING DR SUITE 220
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City | CENTRALIA
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State | IL
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Zip | 62801-3000
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Country | US
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Telephone | 618-545-1705
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Fax | 618-545-1703
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Provider Business Mailing Address
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Address Line | 1054 MARTIN LUTHER KING DR SUITE 220
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City | CENTRALIA
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State | IL
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Zip | 62801-3000
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Country | US
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Telephone | 618-545-1705
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Fax | 618-545-1703
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209009461
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License Number State | IL
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