Healthcare Provider Details

I. General information

NPI: 1982757225
Provider Name (Legal Business Name): SHIELA JOANNE SCHUMACHER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 EAST. NICOLLET BOULEVARD
BURNSVILLE MN
55337
US

IV. Provider business mailing address

26900 CHOWEN AVE
ELKO MN
55020-9747
US

V. Phone/Fax

Practice location:
  • Phone: 952-892-2181
  • Fax:
Mailing address:
  • Phone: 952-242-4203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR176905-2
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: