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General NPI Number Information
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NPI Number | 1124008776
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Entity Type | Individual
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Provider Name | JEANETTE FRANCES CHRISTINA SHIMKUS D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/04/2019
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Provider Practice Location Address
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Address Line | 801 GREENBRIER PKWY STE B
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3822
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Country | US
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Telephone | 757-819-7547
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Fax | 757-842-6570
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Provider Business Mailing Address
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Address Line | 801 GREENBRIER PKWY STE B
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3822
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Country | US
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Telephone | 757-819-7547
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Fax | 757-842-6570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2013-01572
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 215878
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102202597
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License Number State | VA
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