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General NPI Number Information
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NPI Number | 1003280975
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Entity Type | Individual
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Provider Name | CHARVETTE GAITONE SHUMAKER-KIRK AGACNP-; AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 36 LINDEN AVE NE
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City | ATLANTA
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State | GA
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Zip | 30308-2951
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Country | US
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Telephone | 404-778-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 7891 GABLE DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-6403
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | RN193221
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN193221
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN193221
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN193221
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License Number State | GA
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