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General NPI Number Information
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NPI Number | 1255306551
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Entity Type | Individual
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Provider Name | SANDRA LOUISE SHUMAKER ACNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 921 SPYGLASS CIR CNOS, PC
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5101
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Country | US
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Telephone | 712-490-8422
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Fax |
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Provider Business Mailing Address
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Address Line | 921 SPYGLASS CIR CNOS, PC
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5101
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Country | US
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Telephone | 712-490-8422
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | CP000461
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | L113973
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 111169
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License Number State | NE
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