MEDICARE: SHIMEAKER NICOLE HAMPTON FULL SPECTRUM DOULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula	NONE	OH

General Provider Information

NPI Number	:	1033673215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIMEAKER NICOLE HAMPTON FULL SPECTRUM DOULA

Provider Business Mailing Address
First Line	:	5591 DALEWOOD AVE
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-3435
Country	:	US
Telephone Number	:	216-301-9956
Fax Number	:

Provider Business Practice Location Address
First Line	:	5591 DALEWOOD AVE
Second Line	:
City	:	MAPLE HEIGHTS
State	:	OH
Zip	:	44137-3435
Country	:	US
Telephone Number	:	216-301-9956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	01/22/2019

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