Provider Demographics
NPI:1285653030
Name:SCHIMERS, CHERYL J (NP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:J
Last Name:SCHIMERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9861 DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48023-2817
Mailing Address - Country:US
Mailing Address - Phone:586-725-3509
Mailing Address - Fax:
Practice Address - Street 1:1030 HARRINGTON BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:MT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043
Practice Address - Country:US
Practice Address - Phone:586-493-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704120604363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4692030Medicaid
MI4692030Medicaid
MIOP11450Medicare ID - Type Unspecified