Healthcare Provider Details

I. General information

NPI: 1558761213
Provider Name (Legal Business Name): LINDSAY K SHUMATE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2014
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 AVON ST
FAYETTEVILLE NC
28304-4423
US

IV. Provider business mailing address

4904 WINGED FOOT LN N
WILSON NC
27896-9194
US

V. Phone/Fax

Practice location:
  • Phone: 910-729-6552
  • Fax: 910-500-1002
Mailing address:
  • Phone: 484-356-6637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5010509
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: