Provider Demographics
NPI:1649232042
Name:SCHMIDT-SKILLEN, MARLENE M (DC)
Entity Type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:M
Last Name:SCHMIDT-SKILLEN
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 1:546 PELL AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151
Mailing Address - Country:US
Mailing Address - Phone:540-483-7620
Mailing Address - Fax:540-483-9899
Practice Address - Street 1:546 PELL AVENUE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151
Practice Address - Country:US
Practice Address - Phone:540-483-7620
Practice Address - Fax:540-483-9899
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA337526OtherANTHEM
VA350001098OtherMEDICARE
VA700026275OtherCIGNA
VA7470475OtherAETNA
VA7470475OtherAETNA