Provider Demographics
NPI:1912523432
Name:SHUMATE, ABBY MARIAH (DNP, ARNP, AGACNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:MARIAH
Last Name:SHUMATE
Suffix:
Gender:F
Credentials:DNP, ARNP, AGACNP-BC
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:MARIAH
Other - Last Name:SONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:506 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-1205
Mailing Address - Country:US
Mailing Address - Phone:563-468-3206
Mailing Address - Fax:
Practice Address - Street 1:1227 E RUSHOLME ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2459
Practice Address - Country:US
Practice Address - Phone:563-421-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH159849363LA2100X
IL209.021655363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care