Provider Demographics
NPI:1568656718
Name:SHUMATE, BOYD S (ARNP)
Entity Type:Individual
Prefix:
First Name:BOYD
Middle Name:S
Last Name:SHUMATE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SW OAKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1995
Mailing Address - Country:US
Mailing Address - Phone:785-233-1730
Mailing Address - Fax:785-233-0085
Practice Address - Street 1:330 SW OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1995
Practice Address - Country:US
Practice Address - Phone:785-233-1730
Practice Address - Fax:785-233-0085
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46054364SP0809X
MO2011035319363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult