Provider Demographics
NPI:1477185817
Name:SCHUMER, DEBRA ANN (RD, LD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:SCHUMER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 COUNTY ROAD 318
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-8072
Mailing Address - Country:US
Mailing Address - Phone:573-579-3415
Mailing Address - Fax:
Practice Address - Street 1:1616 COUNTY ROAD 318
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-8072
Practice Address - Country:US
Practice Address - Phone:573-579-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001004305133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered