Provider Demographics
NPI:1386669737
Name:SCHENKEL, NICOLE TRZECIAK (PT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:TRZECIAK
Last Name:SCHENKEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-1991
Mailing Address - Country:US
Mailing Address - Phone:352-870-6826
Mailing Address - Fax:
Practice Address - Street 1:2101 NORTHSIDE DR.
Practice Address - Street 2:SUITE 502
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:850-913-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist