Provider Demographics
NPI:1043049364
Name:SCHUTZ, MADISON MCKENZIE (CPNP-AC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MCKENZIE
Last Name:SCHUTZ
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 TURNBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2407
Mailing Address - Country:US
Mailing Address - Phone:443-805-4859
Mailing Address - Fax:
Practice Address - Street 1:1206 TURNBRIDGE RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2407
Practice Address - Country:US
Practice Address - Phone:443-805-4859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR245264363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics