Healthcare Provider Details

I. General information

NPI: 1568398907
Provider Name (Legal Business Name): SHERIDAN BROOKE SCHIMMELPFENNIG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 PERIMETER PKWY
AUGUSTA GA
30909-5797
US

IV. Provider business mailing address

1815 CURTIS DR
NORTH AUGUSTA SC
29841-2206
US

V. Phone/Fax

Practice location:
  • Phone: 706-842-1212
  • Fax:
Mailing address:
  • Phone: 918-779-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP004890
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number31402
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: