Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP7762 | AZ |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP7762 | AZ |
NPI | 1053798967 |
---|---|
Provider Name | Nicholas Peter Schumacher |
First Address | Flagstaff, AZ 86002-0967 |
Second Address | Flagstaff, AZ 86001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 27/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
226657 | (05) | AZ |