Provider Demographics
NPI:1093579484
Name:SCHUMACHER, KATELYNN (FNP)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATELYNN
Other - Middle Name:
Other - Last Name:WEATHERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13987 N CASCADE ST
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-8539
Mailing Address - Country:US
Mailing Address - Phone:208-503-0253
Mailing Address - Fax:
Practice Address - Street 1:2170 W IRONWOOD CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2606
Practice Address - Country:US
Practice Address - Phone:208-665-5596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID50320163WE0003X
ID78974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency