Provider Demographics
NPI:1669446084
Name:SHUMATE, WENDY SHEW (FNP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SHEW
Last Name:SHUMATE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-7756
Mailing Address - Country:US
Mailing Address - Phone:336-849-4171
Mailing Address - Fax:336-849-4170
Practice Address - Street 1:755 S STATE ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-7756
Practice Address - Country:US
Practice Address - Phone:336-849-4171
Practice Address - Fax:336-849-4170
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201391363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE704Medicare PIN
NC2804945AMedicare UPIN