Provider Demographics
NPI:1578949707
Name:SHUSTER, DAYNA RAE-ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:RAE-ANN
Last Name:SHUSTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DAYNA
Other - Middle Name:RAE-ANN
Other - Last Name:COMPEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:715 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-5382
Mailing Address - Country:US
Mailing Address - Phone:989-794-3200
Mailing Address - Fax:989-794-3215
Practice Address - Street 1:715 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640
Practice Address - Country:US
Practice Address - Phone:989-794-3200
Practice Address - Fax:989-794-3215
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007395363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant