Healthcare Provider Details

I. General information

NPI: 1568656718
Provider Name (Legal Business Name): BOYD S SHUMATE ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SW OAKLEY AVE
TOPEKA KS
66606-1995
US

IV. Provider business mailing address

330 SW OAKLEY AVE
TOPEKA KS
66606-1995
US

V. Phone/Fax

Practice location:
  • Phone: 785-233-1730
  • Fax: 785-233-0085
Mailing address:
  • Phone: 785-233-1730
  • Fax: 785-233-0085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number46054
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2011035319
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: