Individual
DEANNA SHUMATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.489178
OH
164W00000X
Licensed Practical Nurse
LPN.159523.MEDS-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0390621
—
OH
Enumeration date
01/10/2018
Last updated
06/23/2022
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