Provider Demographics
NPI:1558703488
Name:SCHUMACHER, BETHENY LYN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BETHENY
Middle Name:LYN
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BETHENY
Other - Middle Name:LYN
Other - Last Name:FRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13301 GATEWAY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-2984
Mailing Address - Country:US
Mailing Address - Phone:703-819-2883
Mailing Address - Fax:
Practice Address - Street 1:10301 NEW GUINEA RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-3268
Practice Address - Country:US
Practice Address - Phone:703-764-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001222593163W00000X
VA0024171002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse