Individual
KRYSTAL SUSAN SHOUMAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS-5284
Contact information
Practice address
205 S PRATT AVE, CARSON CITY, NV 89701-4730
(775) 882-3945
(775) 882-6126
Mailing address
205 S PRATT AVE, CARSON CITY, NV 89701-4730
(775) 882-3945
(775) 882-6126
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PRSS-5284
NV
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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