Healthcare Provider Details

I. General information

NPI: 1336060904
Provider Name (Legal Business Name): KARISSA SHUMAKER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARISSA PLUIMER AUD

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 WESTERN BLVD STE L
JACKSONVILLE NC
28546-6852
US

IV. Provider business mailing address

506 WEATHERFORD DR
JACKSONVILLE NC
28540-4280
US

V. Phone/Fax

Practice location:
  • Phone: 910-335-9310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number30005380
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: