Healthcare Provider Details

I. General information

NPI: 1235152935
Provider Name (Legal Business Name): GRETCHEN C SCHUMACHER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/16/2024
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 MAIN ST
NORTH HAVEN ME
04853
US

IV. Provider business mailing address

PO BOX 400
NORTH HAVEN ME
04853-0400
US

V. Phone/Fax

Practice location:
  • Phone: 207-867-2021
  • Fax: 207-867-2256
Mailing address:
  • Phone: 207-867-2021
  • Fax: 207-867-2256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704265270
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704265270
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP241037
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: