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General NPI Number Information
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NPI Number | 1740178128
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Entity Type | Individual
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Provider Name | MICHAELYN JAMES AJAKI SHUMWAY
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 393 E RIVERSIDE DR STE 3A
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City | SAINT GEORGE
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State | UT
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Zip | 84790-7127
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Country | US
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Telephone | 435-688-2123
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Fax |
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Provider Business Mailing Address
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Address Line | 485 DIAGONAL ST APT 7
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City | SAINT GEORGE
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State | UT
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Zip | 84770-5716
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10046318
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 12807360-4405
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License Number State | UT
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