Provider Demographics
NPI:1235152935
Name:SCHUMACHER, GRETCHEN C (CRNP)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:C
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:CRNP
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:NORTH HAVEN
Mailing Address - State:ME
Mailing Address - Zip Code:04853-0400
Mailing Address - Country:US
Mailing Address - Phone:207-867-2021
Mailing Address - Fax:207-867-2256
Practice Address - Street 1:135 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:ME
Practice Address - Zip Code:04853
Practice Address - Country:US
Practice Address - Phone:207-867-2021
Practice Address - Fax:207-867-2256
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704265270363LF0000X, 363LG0600X
MECNP241037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1235152935Medicaid
MI1235152935Medicaid