Provider Demographics
NPI:1992842785
Name:SHUMAKE, CARMA L (APN)
Entity Type:Individual
Prefix:
First Name:CARMA
Middle Name:L
Last Name:SHUMAKE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2029
Mailing Address - Country:US
Mailing Address - Phone:501-686-5021
Mailing Address - Fax:
Practice Address - Street 1:1393 HIGHWAY 242 S
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-8851
Practice Address - Country:US
Practice Address - Phone:870-572-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA001098363LF0000X
ARA01098363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR201477729Medicaid
AR201478729Medicaid
AR136428729Medicaid
AR201479729Medicaid
AR201481729Medicaid
AR129735729Medicaid
AR100907002Medicaid
AR129734729Medicaid
AR201482729Medicaid
AR201481729Medicaid
AR201477729Medicaid
AR201482729Medicaid
AR043489Medicare Oscar/Certification
AR201478729Medicaid
AR136428729Medicaid
AR043456Medicare Oscar/Certification