Provider Demographics
NPI:1558897066
Name:SCHMOKER, CORINNE
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:SCHMOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 6TH AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-3632
Mailing Address - Country:US
Mailing Address - Phone:701-253-3656
Mailing Address - Fax:701-952-3650
Practice Address - Street 1:214 6TH AVE NE STE A
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-3632
Practice Address - Country:US
Practice Address - Phone:701-253-3656
Practice Address - Fax:701-952-3650
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND17OtherTAXONOMY