Healthcare Provider Details

I. General information

NPI: 1992842785
Provider Name (Legal Business Name): CARMA L SHUMAKE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1393 HIGHWAY 242 S
HELENA AR
72342-8851
US

IV. Provider business mailing address

4021 W 8TH ST
LITTLE ROCK AR
72204-2029
US

V. Phone/Fax

Practice location:
  • Phone: 870-572-2727
  • Fax:
Mailing address:
  • Phone: 501-686-5021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA001098
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA01098
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: