Healthcare Provider Details

I. General information

NPI: 1043034739
Provider Name (Legal Business Name): DESIREE LYNN SCHUMANN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESIREE LYNN MASCIARELLI RN

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 HOSPITAL DR
VICTORIA TX
77901-5749
US

IV. Provider business mailing address

1223 FANNIN OAKS
VICTORIA TX
77905-3088
US

V. Phone/Fax

Practice location:
  • Phone: 361-573-9181
  • Fax:
Mailing address:
  • Phone: 361-648-2203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number660194
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: