Provider Demographics
NPI:1114237419
Name:SHUMAN, ELIZABETH (RNPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SHUMAN
Suffix:
Gender:F
Credentials:RNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 MAPLE ST
Mailing Address - Street 2:CENTER FOR HEALTHY AGING
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-4065
Mailing Address - Country:US
Mailing Address - Phone:978-646-7070
Mailing Address - Fax:978-750-6988
Practice Address - Street 1:480 MAPLE ST
Practice Address - Street 2:CENTER FOR HEALTHY AGING
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-4065
Practice Address - Country:US
Practice Address - Phone:978-646-7070
Practice Address - Fax:978-750-6988
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN103020364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health