Provider Demographics
NPI:1235556002
Name:SHUMAKER, WHITNEY
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:SHUMAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASPERMONT
Mailing Address - State:TX
Mailing Address - Zip Code:79502-2029
Mailing Address - Country:US
Mailing Address - Phone:940-989-3551
Mailing Address - Fax:940-989-3395
Practice Address - Street 1:821 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ASPERMONT
Practice Address - State:TX
Practice Address - Zip Code:79502-2029
Practice Address - Country:US
Practice Address - Phone:940-989-3551
Practice Address - Fax:940-989-3395
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08841363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical