MEDICARE: ZACHARY SCHIMMOLLER RN

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	163W00000X	Registered Nurse	RN.1695072	CO

General Provider Information

NPI Number	:	1275480840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY SCHIMMOLLER RN

Provider Business Mailing Address
First Line	:	460 FLATIRON BLVD UNIT 3050
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80021-8395
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 RIVERBEND RD # 300
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-2613
Country	:	US
Telephone Number	:	303-415-7000
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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