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General NPI Number Information
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NPI Number | 1811587850
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Entity Type | Organization
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Legal Business Name | NICOLE SCHUMANN PSYD, LP, LLC
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Dates
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Enumeration Date | 01/23/2021
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Last Update Date | 01/23/2021
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Provider Practice Location Address
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Address Line | 12400 PORTLAND AVE STE 120
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City | BURNSVILLE
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State | MN
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Zip | 55337-6817
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Country | US
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Telephone | 952-236-6189
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Fax | 952-213-6116
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Provider Business Mailing Address
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Address Line | 12400 PORTLAND AVE STE 120
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City | BURNSVILLE
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State | MN
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Zip | 55337-6817
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Country | US
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Telephone | 952-236-6189
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Fax | 952-213-6116
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICOLE M SCHUMANN
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Credential | PSYD
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Telephone | 651-343-0850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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