Provider Demographics
NPI:1871792630
Name:SCHOUMAKER, KAREN MICHELLE (CRNA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:SCHOUMAKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MICHELLE
Other - Last Name:KAWALEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8990 SPRINGBROOK DR NW
Mailing Address - Street 2:SUITE250
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5850
Mailing Address - Country:US
Mailing Address - Phone:763-398-1168
Mailing Address - Fax:763-398-0124
Practice Address - Street 1:8990 SPRINGBROOK DR NW
Practice Address - Street 2:SUITE250
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5850
Practice Address - Country:US
Practice Address - Phone:763-398-1168
Practice Address - Fax:763-398-0124
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1529852367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN53L87SCOtherBCBSMN
MN550907100Medicaid
MN53L87SCOtherBCBSMN