Provider Demographics
NPI:1326086927
Name:SHUMAN, MARCI L (MS CCC A)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:L
Last Name:SHUMAN
Suffix:
Gender:F
Credentials:MS CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E KENTUCKY STREET
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2793
Mailing Address - Country:US
Mailing Address - Phone:502-515-3320
Mailing Address - Fax:502-515-3325
Practice Address - Street 1:117 E KENTUCKY STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2793
Practice Address - Country:US
Practice Address - Phone:502-584-3573
Practice Address - Fax:502-583-6364
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0437231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00361111OtherRAILROAD MEDICARE
IN200819360Medicaid
KY70001325Medicaid
KY000000380730OtherANTHEM
KY70001325Medicaid
KYP00361111OtherRAILROAD MEDICARE