Provider Demographics
NPI:1629890173
Name:SCHUMAN, TAYLOR LYNN (RN, QSP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LYNN
Last Name:SCHUMAN
Suffix:
Gender:F
Credentials:RN, QSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3383 PRIMROSE CT APT C16
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-8508
Mailing Address - Country:US
Mailing Address - Phone:701-215-7900
Mailing Address - Fax:
Practice Address - Street 1:401 N 12TH ST APT 4
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-3165
Practice Address - Country:US
Practice Address - Phone:701-517-2164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR56059163WE0003X, 163WP2201X
3747P1801X
NDRN56059163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDR56059OtherND BON