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NPI Code Detail

MEDICARE: MS. CYNTHIA ANN SCHACKMAN ARNP OR PFMHNP

MEDICARE: MS. CYNTHIA ANN SCHACKMAN ARNP OR PFMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR1590218MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154419877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNTHIA ANN SCHACKMAN ARNP OR PFMHNP
Provider Business Mailing Address
First Line : 1526 30TH ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4140
Country : US
Telephone Number : 218-751-0887
Fax Number : 218-759-4807
Provider Business Practice Location Address
First Line : 1526 30TH ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4140
Country : US
Telephone Number : 218-751-0887
Fax Number : 218-759-4807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 05/12/2025

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