Provider Demographics
NPI:1851541064
Name:SCHRUMM, SALLY B (APRN)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:B
Last Name:SCHRUMM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-7048
Mailing Address - Country:US
Mailing Address - Phone:203-284-2800
Mailing Address - Fax:203-294-3294
Practice Address - Street 1:GAYLORD FARM RD
Practice Address - Street 2:GAYLORD HOSPITAL
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-284-2800
Practice Address - Fax:203-294-3294
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE34960163W00000X
CT003882363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse