Healthcare Provider Details

I. General information

NPI: 1255188074
Provider Name (Legal Business Name): MINDY SCHUMACHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 98TH ST SE
VENTURIA ND
58413
US

IV. Provider business mailing address

3510 98TH ST SE
VENTURIA ND
58413-9137
US

V. Phone/Fax

Practice location:
  • Phone: 701-731-0180
  • Fax:
Mailing address:
  • Phone: 701-731-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberR52790
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code163WN0003X
TaxonomyLow-Risk Neonatal Registered Nurse
License NumberR52790
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: