Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4913-33 | WI |
NPI | 1013264571 |
---|---|
Provider Name | Alicia Schumacher |
First Address | Marshfield, WI 54449-5702 |
Second Address | Minocqua, WI 54548-9099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2012 |
Last Update Date | 23/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013264571 | (05) | WI |