Provider Demographics
NPI:1427101054
Name:SCHUMACHER, RONALD JOSEPH (CRNA)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:JOSEPH
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26900 CHOWEN AVE
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:MN
Mailing Address - Zip Code:55020-9747
Mailing Address - Country:US
Mailing Address - Phone:952-242-4203
Mailing Address - Fax:
Practice Address - Street 1:26900 CHOWEN AVE
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:MN
Practice Address - Zip Code:55020-9747
Practice Address - Country:US
Practice Address - Phone:952-242-4203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR176904-9367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN127D5SCOtherBCBSMN
MN863445000Medicaid
MN430006005Medicare PIN