Provider Demographics
NPI:1467937490
Name:SCHROEDER, NICOLE HELEN (DC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:HELEN
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337A JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-1809
Mailing Address - Country:US
Mailing Address - Phone:920-385-1750
Mailing Address - Fax:920-744-1442
Practice Address - Street 1:2337A JACKSON ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-1809
Practice Address - Country:US
Practice Address - Phone:920-385-1750
Practice Address - Fax:920-744-1442
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5224-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor