MEDICARE: NICOLE RENE SCHIMKE-JONES DC

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	111N00000X	Chiropractor	2635	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366472094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE RENE SCHIMKE-JONES DC

Provider Business Mailing Address
First Line	:	W 309 S 4860 COMMERCIAL DRIVE
Second Line	:	STE B
City	:	NORTH PRAIRIE
State	:	WI
Zip	:	53153
Country	:	US
Telephone Number	:	262-968-9891
Fax Number	:	262-968-9782

Provider Business Practice Location Address
First Line	:	W 309 S 4860 COMMERCIAL DRIVE
Second Line	:	STE B
City	:	NORTH PRAIRIE
State	:	WI
Zip	:	53153
Country	:	US
Telephone Number	:	262-968-9891
Fax Number	:	262-968-9782

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	12/15/2011

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