Provider Demographics
NPI:1154316248
Name:SCHUMACHER, LORI R (PA-C)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:R
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20100 565TH AVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6607
Mailing Address - Country:US
Mailing Address - Phone:507-381-1626
Mailing Address - Fax:
Practice Address - Street 1:165 W COMMERCE DR
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:MN
Practice Address - Zip Code:56011-2911
Practice Address - Country:US
Practice Address - Phone:952-777-5661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10352363AM0700X, 363A00000X
NE1047363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN970004505Medicare PIN