Provider Demographics
NPI:1295588267
Name:SHUMAKER, TIERNEY L
Entity type:Individual
Prefix:
First Name:TIERNEY
Middle Name:L
Last Name:SHUMAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2890 WIGEON WAY APT 205
Mailing Address - Street 2:
Mailing Address - City:COVENTRY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44319-5753
Mailing Address - Country:US
Mailing Address - Phone:330-813-8069
Mailing Address - Fax:
Practice Address - Street 1:2890 WIGEON WAY APT 205
Practice Address - Street 2:
Practice Address - City:COVENTRY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44319-5753
Practice Address - Country:US
Practice Address - Phone:330-813-8069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker