Healthcare Provider Details

I. General information

NPI: 1285810978
Provider Name (Legal Business Name): NICOLE SCHIMKE FLYNN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE LYNN SCHIMKE

II. Dates (important events)

Enumeration Date: 01/13/2008
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 3RD ST DULUTH CLINIC
DULUTH MN
55805-1951
US

IV. Provider business mailing address

400 EAST 3RD STREET DULUTH CLINIC
DULUTH MN
55804
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-1234
  • Fax: 218-786-3065
Mailing address:
  • Phone: 218-786-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number50333
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: